New York State Intelligence Center¶
Latham, New York 12110¶
REQUEST FOR INFORMATION FORM¶
| DATE & TIME OF REQUEST | MEMBER/ANALYST ASSIGNED I | ||||
|---|---|---|---|---|---|
| RICS Control #: | Rank: | ||||
| Received/Entered By: | Last Name: | ||||
| Date: Time: | Tax / SS#: | ||||
| REQUESTOR’S INFORMATION | |||||
| Agency Name and NY03030C9 ORI: | Command/Unit: | Investigation Child Exploit T/F Type: | Child Exploitation | ||
| Workplace (Full Address): 26 Federal Plaza, New York, NY 10278 | |||||
| Last Name | First Name: | Ftankaitle: | Detective | ||
| Tax # NYPD Only: SSN: | Date of Appointment: | 08/30/1993 | |||
| Office #: Fax A: | Pager/Cell#: | Pin: | |||
| TZS/Pct. Of Occ.: CompIft: | Case#: 2017-212 | Conferred w/ Requestor Date: | Time: | ||
| Supervisor’s Rank/Full Name: Phone Number: LT | |||||
| SUBJECT INFORMATION | |||||
| First Name: Last Name: Maxwell | Ghislaine | Middle: | Aliases: N | ||
| 57 Sex: DOB: Age: | F Race: W POB: | Gang Name: | |||
| Street: Apt: City: Bldg# | |||||
| State: ZIP Code: | Tel# | SSN# | |||
| Arrest: Driver License#: State/Country: FL | |||||
| FBI#: | NYSID#: | Other State SID#: | |||
| BUSINESS LOCATION & FINANCIAL INFORMATION | |||||
| Business Name: | Street: Bldg: | ||||
| City | State: | Zip Code | Tel#: | ||
| Last Name: | First Name: | (Circle One) | Owner/Mgr/Employee | ||
| Tax ID#: Financial Institution: Account Type: | |||||
| VEHICLE INFORMATION | |||||
| Plate #: State/Country: | Year: | Make: | Model: | ||
| No. Doors/Body Style: | Color: | Gray | VIN#: | ||
| REMARKS | |||||
| What have you (Requestor) done? | |||||
| What needs to be done by NYSIC personnel? | |||||
| I am requesting a CIAS search of the above named female for the past one year. | |||||
| EMAIL Request to NYSIC: OR | |||||
| to verify that your FAX was received!) FAX Request to NYSIC: (You MUST call |