Date: __________________________
TO: Ron Cryderman , LPD Evidence
PO Box 128
Longview WA 98632
SUBJECT: Claim on Property
FROM: ____________________ __
Full Name
________________________
Address
________________________
Phone Number
I would like to claim the item(s) listed below as possibly being my property.
Bar Code # Case# Description
I lost possession of this property under the following police report
number:___________________ with: _____________________.
Case Number Investigating Agency
I understand that I must show proof of ownership or provide proof that I have reported the item(s) above as stolen or lost.
________________________________________
Signature
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Claim reviewed with the following comments:
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