Missing Person Fact Sheet

Lost and Missing in Indian Country
Missing Person Fact Sheet
Please fill in this form as completely as possible so the case can be intaked.
Name of Missing Person*

First NameLast Name
Maiden Name or AKA
Date of Birth or Age
Sex
Native
Last Known Location (City, County, State)
Is this on any Reservation?
If so, please specify?
Tribal Affiliation
Date Last Seen
Circumstances when person went missing?

Personal Descriptors
Hair Color
Facial Hair
Eye Color
Height
Weight
Scars or Marks
Tattoos
Any Unique/Distinctive Features?
If so, please describe
Medical Implants/Aids?
If so, please describe
Clothing - Accessories - Jewelry
Any Medical or Mental Issues?
Any Drug or Alcohol Issues?
Telephone of Missing Person?
Any Social Media Accounts?
Photo of Missing Person

Next of Kin or Relative Contact
Name
Location (City, State)
Telephone Number
Email

Law Enforcement
Has a Law Enforcement Report Been Made?
Report Number
Law Enforcement Agency Reported To?
In NCIC?
Number

Reporting Party
Name
Relation to Missing Person
Location (City, State)
Telephone Number
Email
Date Case Intaked
Lost and Missing in Indian Country releases contact information to official Criminal Justice Agencies as it pertains to this missing person case.

Official Criminal Justice agencies may include the investing law enforcement agency, the National Center for Missing/Exploited Children (NCMEC) and the National Missing and Unidentified Person System (NamUs).
Should be Empty: