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 Command/Unit: NY03030C9 ORI: | Child Investigation Child Exploit T/F Type: Exploitation |
| Workplace (Full Address): 26 Federal Plaza, New York, NY 10278 | |
| First Name: Last Name | Ftankaitle: Detective |
| Tax # NYPD Only: SSN: | Date of Appointment: 08/30/1993 |
| Office #: Fax A: | Pin: Pager/Cell#: |
| TZS/Pct. Of Occ.: CompIft: Case#: 2017-212 | Conferred w/ Requestor Date: Time: |
| LT Supervisor’s Rank/Full Name: Phone Number: | |
| SUBJECT INFORMATION | |
| First Name: Last Name: Borgerson Scott | Middle: G Aliases: |
| M W DOB: Age: 44 Sex: Race: | POB: Gang Name: |
| Apt: City: Bldg# Street: | |
| ZIP Code: Tel# State: | SSN# |
| Driver License#: MA Arrest: State/Country: S | |
| FBI#: NYSID#: | Other State SID#: |
| BUSINESS LOCATION & FINANCIAL INFORMATION | |
| Business Bldg: Street: Name: | |
| City State: | Zip Code Tel#: |
| First Name: Last Name: | (Circle One) Owner/Mgr/Employee |
| Tax ID#: Financial Institution: Account Type: | |
| VEHICLE INFORMATION | |
| Plate it: State/Country: | Make: Model: Year: |
| Color: No. Doors/Body Style: | 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 male for the past one year. | |
| EMAIL Request to NYSIC: ciu n csic.n . ov OR | |
| FAX Request to NYSIC: (You MUST call to verify that your FAX was received!) |
New York State Intelligence Center¶
Latham, New York 12110¶
REQUEST FOR INFORMATION FORM¶
| DATE & TIME OF REQUEST | MEMBER/ANALYST ASSIGNED | |||||||
|---|---|---|---|---|---|---|---|---|
| RICS Control #: | Rank: | |||||||
| Received/Entered By: | Last Name: | |||||||
| Date: | Time: | Tax / SS#: | ||||||
| REQUESTOR’S INFORMATION | ||||||||
| Agency Name and ORI: | NY03030C9 | Command/Unit: | Child Exploit T/F | Investigation Type: | Sex Trafficking | |||
| Workplace (Full Address): 26 Federal Plaza, New York, NY 10278 | ||||||||
| Last Name | First Name: | Rank/Title: | Detective | |||||
| Tax # NYPD Only: | SSN: | Date of Appointment: | 08/30/1993 | |||||
| Office #: | Fax #: | Pager/Cell#: | Pin: | |||||
| TZS/Pct. Of Occ.: | Compl#: | Case#: | 31E-NY- 302870 | Conferred w/ Requestor Date: | Time: | |||
| LT Supervisor’s Rank/Full Name: Phone Number: - | ||||||||
| SUBJECT INFORM TION | ||||||||
| Last Name: | First Name: | Middle: | Aliases: | |||||
| DOB: Age: | Sex | Race: | POB: | Gang Name: | ||||
| Street: Bldg# | Apt: | City: | ||||||
| State: Code: | Tel# | SSN# | ||||||
| Driver License#: | State/Country: | Arrest: | ||||||
| FBI#: | Other State SID#: NYSID/4: | |||||||
| BUSINESS LOCATION & FINANCIAL INFORMATION | ||||||||
| Business Name: | Bldg: | Street: | ||||||
| City | State: | Zip Code | Tel#: | |||||
| Last Name: | First Name: | (Circle One) | Owner/Mgr/Employee | |||||
| Tax ID/4: | Financial Institution: Account Type: | |||||||
| VEHICLE INFORMATION | ||||||||
| Plate #: | State/Country: | MA | Year: | 19 | Make: | CHEV | 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 the assistance of the NYSP regarding a CIAS check as well as NYSP , LPR’s,. | ||||||||
| EMAIL Request to NYSIC: ciu6i)nvsic.nv.eov OR |
EFTA00038392¶