DPS Laboratory Case Number:
Agency	Phone #
Agency Contact	Fax #
Agency Contact Signature	Agency Case #

Required Information for Digital/Multimedia Evidence Submissions
Are there known victims in this case?	Yes No Unknown
If yes, is the suspect(s) an immediate threat to the victim or other potential victims? (Do not leave this area blank)	Yes No
Is the suspect currently incarcerated?	Yes No
Required Valid Digital/Multimedia Evidence Search Warrant or Consent to Search
Does the search warrant or consent form include specific verbiage allowing Laboratory personnel to forensically recover/extract data stored on the submitted media?	Yes No
Is the evidence submitted under written consent to search?	Yes No
Is the evidence submitted under verbal consent to search?	Yes No
PLEASE NOTE: If a valid search warrant or consent to search is not received, analysis cannot begin on the case and a 5-business day waiting period will begin from the date of submission.
Data Dump: Select “Yes” to request only a dump of the extracted and parsed data from the evidence. No analysis will be performed by the laboratory. Please note that it is required that the Digital/Multimedia Waiver be filled out for data dump requests.	Yes No
For Vehicle Infotainment/Telematics modules: Please indicate if the evidence should be mailed back to you or returned in person. Please note that vehicles are typically disabled while the module is removed. There may be risk of loss or damage associated with sending modules in the mail. When mailing vehicle evidence, please ensure the module is secured in protective packaging.	Mail Return In Person Return

Provide range of relevant dates and times for examination, if known: Provide the evidence collection date, if known (this may help us prioritize devices of which certain artifacts may be systematically purged by the device operating system): Provide any known passcodes to the submitted mobile devices: Provide involved parties’ names and usernames, keywords and as much detail regarding the offense as possible; and/or provide a copy of the offense report.