H.I.P.S.

1-833-557-BARC (2272)

Matrimonial/ Infidelity Form

Appendix 'A'

Please DO NOT SUBMIT if you DO NOT WANT A CALL BACK. The CEO only speaks with select individuals who are seriously in need of our assistance and need to hire a Private Investigator

Surveillance to be conducted on:

Have you hired a Private Investigator before?

If yes, was it regarding this case?

Yes

Unknown

Did the investigation cease?

Client's First Name

Client's Last Name

Client's Address

Client's Email

Client's Cell Phone

Client's Home Phone

Client - Tell your story, the who, what, where, when and how.

Subject 1

Date of Birth

Address

Subject 1's Photograph

Upload file

Subject 1's Motor Vehicle

Subject 1's Motor Vehicle's Make, Model, and Colour

Photo of Subject 1's Motor Vehicle

Upload file

Does Subject 1 have a Criminal Record?

Yes

Unknown

Does subject 1 own or carry any weapons?

Yes

Unknown

Subject 2 (Possible person having an affair with Subject 1)

What age is Subject 2

Address of Subject 2

Subject 2's Phone #

Photo of Subject 2

Upload file

Subject 2's Motor Vehicle

Subject 2's Motor Vehicle's Make, Model, and Colour

Photo of Subject 2's Motor Vehicle

Upload file

Does Subject 2 have a Criminal Record?

Yes

Unknown

Does subject 2 own or carry any weapons?

Yes

Unknown

Which signs do you see that an Matrimonial/ Infidelity is occurring::

Follow Up to previous question drop down for 'Other'

Number of Years Together?

Number of Children (0-10)

Subject 1's Type of Employment?

If we provide the proof you need, will you:

Leave them and get a divorce

Separate

Go for therapy together

I do not know, "I will need help"

Best time to call you?

Best phone number to contact you on?

Alternate Phone Number to Call

Does the Subject have any upcoming known Appointments coming up?

Is this case to potentially go to court or used in legal proceedings?

Yes

Unknown

I, the client agrees there has never been a charge of Criminal Harassment (Stalking) and includes in person, direct or indirect, and/or cyber stalking including Threatening Bodily Harm or Death?

By checking this box, I, the client agrees there is no Retraining Order, Peace Bond or Protection Order against the client or any of the subject(s) mentioned in this form

Thank you for your submission of this form.