Client Information

First Name

Middle Name

Last Name

Other Names or Aliases

Email

Social Media Profiles

Facebook

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Others

Address

Street Address

Address Line 2

City

State

ZIP / Postal Code

Country

Phone

Mobile

Occupation

Employer

Please describe briefly what you have experienced

How long have you been under electronic surveillance? Please list dates, times and locations

Please list all names of suspects that you feel are responsible for this compromise

Did you ever have an experience with a stalker?
 Yes No

Did you ever file a restraining order against anyone?
 Yes No

Do you know the motive and reasons behind the compromise and eavesdropping surveillance?
 Yes No

Please describe a brief scenario of why you fell this is happening to you

How many square feet is your home?

How many square feet is the area that you feel has been compromised?

Who lives in your home?

Please list all vehicles that you drive include Year, Make and Model:

What computer do you have at home? i.e. laptop, desktop, Mac or Windows

What type of cell phone do you have? Please list all brands and models of cell phone.

Who is your cell phone carrier? i.e. Verizon Wireless, AT&T, T-Mobile, Sprint PCS

How long have you had the cell phone in your possession?

Do you want to prosecute the suspects?
 Yes No

What is most important to you?

How did you find us?

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