Cold Case Request Form

Requestor Information

First Name *

Last Name *

Relationship to Vicim *

Telephone Number *

Street Address *

City *

State *

Zip Code *

Victim Information

First Name *

Last Name *

Date of Death (Approximate) *

Date of Birth

Place of Death *

What agency initially investigated this death?

Thomasville Police Department Case Number:

If a Coleman-Baker Act application has been submitted, other than to the Thomasville Police Department, when was it submitted and to what agency?

Leave this field blank