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        Los Angeles Private Investigators - Investigators Serving Los Angeles and the State of California

        | Case Assignment | Contact Us

        Case Assignment Form

         

        Completing the Case Assignment Form below allows us to conduct a preliminary review of your case so we will better be able to advise you of what steps and fees may be involved in conducting your assignment.

         

        Please supply as much information as possible.

         

        Case Details
        Investigation Type:
        Other:
        Completion Deadline: Day:  Month: Year:
        Trial or Hearing Date: Day:  Month: Year:
        Previous Surveillance Performed? Yes:   No:
        (If yes, we will require a copy of your report)
        Alleged Injury:
        Physical Restrictions:
        Claim Number
        Date of Loss:  Month: Year:
        Insured:
        What is the purpose of this investigation?
        Client Information
        Are you a first time client? Yes
        No
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        Full Name:
        Address:
        Address2:
        City:
        State:
           Zip:
        Phone:
        Fax:
        Email Address:
        Secondary Client Information (if applicable)
        Client:
        Phone:
        Fax:
        Email:
        Subject Details
        Name:
        Address:
        Address2:
        City:
        State:    Zip
        Telephone:
        Date of Birth:
        SSN:
        Drivers Lic. #:
        Subject Identifying Information
        Sex:
        Race:
        Hair:
        Build:
        Height: ft.    in.
        Weight: lbs.
        Other Descriptive Details (tattoos, disabilities, scars, etc.):
        Marital Status:
        Spouse Name:
        Vehicle Information
        Vehicle #1  
        Make:
        Model:
        Color:
        Tag# Year:
        Vehicle #2  
        Make:
        Model:
        Color:
        Tag# Year:
        Further Details
        Does the subject have a history of violent behavior? Yes (If yes, two crews are required)
        No
        Restrictions: Day Limit: Dollar Limit:  
        Are there specific days for the surveillance to be conducted on? Yes   No
        (If yes, please detail)
        If 2 crews are required (ie: rural areas), do we have permission to proceed? Yes
        No
        Special Instructions:
        Has KSI's billing procedures been explained? Yes
        No
        Referred By:


         

        Call Los Angeles Investigators for a FREE consultation

         

        Counsel Investigations is a division of

        Las Vegas, Nevada

         

        California Private Investigators License #CA-PI 26840

         

         

         

        NAVIGATION

         

         

        ADDRESS & PHONE

         

        Counsel Investigations
        4470 W. Sunset Boulevard
        Suite 107-251
        Los Angeles, California 90027
        Toll Free: 877 718 2834

        Los Angeles: (213) 341 0173

        San Francisco: (415) 449 1967
        Fax: 877 718 2835

         

        QUICK CONTACT FORM

        Name:

        Phone:
        E-Mail:

        Question:

         

         

        ONLINE PAYMENTS

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