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Investigative Services Intake Form

Are you a new or existing customer?

New Customer

Existing Customer

First name

Last name

Firm Name

Your Magna Representative

Email Address

Your Physical Address

Country/Region

Address

City

Zip / Postal code

Phone Number

Adjuster

Claim Number

Case Number

File Number

Opposing Counsel

Jurisdiction/Court

Date of Incident

Month

Day

Year

Is this a Rush Job?

No

Yes

Authorized Budget

Type of Job

Service of Process

Social Media & Background Investigations

Medical Canvassing Investigations

Asset Investigations

Locate Investigations/Skip-Tracing

Surveillance/Sub-Rosa

General/Other Investigations

Subject's Information

Subject's Name

DOB

Description of Subject and/or Known Vehicles

SSN

SSN/EIN

Last Known Home Address

Last Known Employer/Work Address

Driver's License Number/State

Any Known Email Address/Phone Numbers

Any Known Social Media Accounts

Any Known Hobbies, Social Groups, etc.

Any Known Relatives, Friends, or Co-workers

Any Known Assets

Brief Explanation as to why Asset Search is Needed

Brief Explanation as to why Skip Trace/Locate is Needed

Additional Investigation Requirements

Social Media Investigation (SMI)

Surveillance/Sub-Rosa

Is there anything else you can think of that might be useful for us to know about the subject or the case?

Information to Investigate

What are the claimed injuries/limitations or matters at issue?

Is there anything else you can think of that might be useful for us to know about the subject or the case?

Documents To Be Filed

Add up to 30 files

Special Instructions

(i.e. deliver courtesy copies, file by noon, etc.)

Information of Person Records Pertain To (Name, SSN, DOB)

Manner of Records Release (Authorization, Subpoena Duces Tecum, Etc.)

Type of Records

Locations to Obtain Records From

Names and Addresses for Opposing Counsel

Special Instructions

(i.e. records limited to certain dates, special wording required, add Bates numbering, produce digital copies only, etc.)

Is there a specific date this must be completed by?

Yes

No

Information to Investigate

Relevant Documents

Add up to 30 files

Investigations License Numbers

CA: 189852

TX: A29790401

Make a Payment

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