Corporate Headquarters
2600 Michelson Drive, 17th Floor • Irvine, CA 92612
Phone (800) 576-6116 • Fax (800) 576-6226
Assignments@RamosInvestigations.com

SUBJECT
First Name, MI, Last Name
AKA
Street Address
City
 State
 		Zip Code
Phone
 SSN
 		DOB (dd/mm/yy)
Occupation
ASSIGNED BY
First Name, MI, Last Name
Company
Street Address
City
 State
 		Zip Code
Phone
 Extension
 		Fax
Email
EMPLOYER
Contact Person Company
Address
 Phone
City
 State
 		Zip Code
INJURY
Date of Injury Type of Injury
Restrictions
 Claim Number
Subject Uses:
Cane Crutch Collar Brace Limps
DEFENSE ATTORNEY
First Name, MI, Last Name
Firm
Address
City
 State

 		Zip Code
Phone
 Extension
 		Fax
Email
ASSIGNMENT
How many days of SURVEILLANCE would you like?
Would you like an ACTIVITY CHECK prior to the surveillance?
May we call contact person for a DESCRIPTION of the subject?
By what DATE do you need the investigation completed?
Has another firm investigated the subject?
IMPORTANT: Please fax or email the previous report to avoid redundancy!
INVESTIGATE

Current Employment

Physical Activities
Business Ownership
Property Ownership
Litigation History
Vehicle Ownership
Driving Record
Secure Police Report
Social Security Trace
Hobbies
Asset Search
Criminal History
Locate
DESCRIPTION OF SUBJECT
Sex
Race
Height Weight Build Hair ( length / color / style )
Eyes Complexion Glasses Tattoo Descriptive Features

Vehicle Description(s)

What indicators of fraud caused you to assign this investigation?

What questions would you like this investigation to answer?

What do you suspect the subject is up to?

Are there any upcoming scheduled medical appointments, or court dates?

Notes: