Stalking Information: Log Sheet 1

Go to Stalking Incident Log Sheet

Offender Information
Information in this section adapted from Sacramento Area Stalking Survivors, Sacramento, CA.

Full Name

  
Nickname/Alias  
Home address (last known):  
Home Phone  
Cell Phone:  
Cell Phone:  
Date of Birth:  
Sex:  
Height:  
Weight:  
Race/Ethnicity:  
Hair Color:  
Eye Color:  
Language(s) spoken:  
Length/Style of Hair:  
Shoe Size:  
Social Security Number:  
Driver's License # and Issuing State:  
Tattoos/Identifying Marks:  
Medications:  
Substance abuse:  
Offender's Employer:  
Employer's Address:  
Employer's Phone:  
Supervisor's Name:  
Work Hours:  
Offender's School:  
School Address:  
Class Schedule Information:  
Probation/Parole Status:  
Probation/Parole Office:  
Do you have reason to believe the
offender has access to a firearm?		  
Where is firearm kept?  
History of use of other weapons:  
History of violence/threats with law
enforcement or others besides
primary victim:		  
Has offender ever threatened suicide:  
Vehicle Information: (Year, Make, Model)  
Color:  
License Plate:  
Other vehicles the offender can access:  

Any additional information concerning
offender travels:

  
Please list family, friends and associates:  

Name:
Address:
Phone:
Relationship:

 

  

Name:
Address:
Phone:
Relationship:

 

  

Name:
Address:
Phone:
Relationship:

 

  

Go to Stalking Incident Log Sheet

[home]
[facts] [q&a] [cyberstalking] [safety] [log] [technology] [statistics] [law] [resources]
[sitemap]