"*" indicates required fields Are you a new or existing customer? New Customer Existing Customer Full Name First Last Firm NameYour Magna Representative*I don't have one/ I don't knowPeter HechtBobette MessickBrendan HuethCandace WinklerChris DenneyChristine SierotowiczDaniel PolettiDeb CurranDenise SpencerDenise SustaitaDominique StratiDonna CarotenutoDustin EisenErika MaladyFranco AlcantaraGail KalnajsGregory KnightHunter LippincottJake CashmerJeff SkeensJenna CarterJennifer ChamblessJessica GimbelJoan JacksonJoseph GlennJulie ZanarasKevin GrodnickKevin JohnsonKristen Craig-ReedKyle KingKyle NearyLarry WolfLee DiamondsteinLena EganLeonardo RodriguezMarjorie TinneyMatthew RichterMeredith CherryNick ShermanNicole PalmNinette CanedaNoelle NocitiPeter SilvermanRoss SuterRyan RosenbergSarah CurrenSean MauroSean TillerySoren GenotStephan McCreeTom ZanarasEmail Address*Your Physical Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone NumberReference Number / Billing CodeAdjusterClaim NumberCase NameCase NumberFile NumberOpposing CounselJurisdiction/CourtDate of Incident MM slash DD slash YYYY Is This a Rush Job? No Yes Please Select a Deadline for your Rush Job MM slash DD slash YYYY 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 PLEASE NOTE: If you’re looking for our more surface level social media research, please click here to order our Standard ClaimScout instead.Subject’s InformationSubject's NameDOBDescription of Subject and/or Known VehiclesSSNSSN/EINLast Known Home AddressLast Known Employer/Work AddressDriver's License Number/StateAny Known Email Address/Phone NumbersAny Known Social Media AccountsAny Known Hobbies, Social Groups, etc.Any Known Relatives, Friends, or Co-workersAny Known AssetsBrief Explanation as to why Asset Search is NeededBrief Explanation as to why Skip Trace/Locate is NeededAdditional 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?In addition to or in lieu of completing the above section, you may also submit relevant case documents (i.e. depo transcripts, discovery responses, etc.) Drop files here or Select files Max. file size: 128 MB. Type of Asset Search Needed Basic – Includes basic searching for properties, vehicles, judgments/liens, business ownership, and bank accounts Standard – Includes thorough searching for all previously listed areas Comprehensive – Includes thorough searching for all previously listed areas as well as brokerage accounts and Open Source Intelligence (OSINT) information Other Please describe the type of asset search you needInformation to InvestigateWhat 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?Is there a specific number of days needed and/or are there specific dates/times needed?Note that our standard practice is 3 days unless otherwise specifiedIn addition to or in lieu of completing the above section, you may also submit relevant case documents (i.e. depo transcripts, discovery responses, etc.). Please also include a photo of the subject if one is available. Drop files here or Select files Max. file size: 128 MB. Additional Investigation Requirements A Social Media Investigaiton (SMI) is also needed A Medical Canvassing Investigation (MCI) is also needed Once Located Report Findings and Close Out Serve Legal Documents (please upload documents to be served) Complete Discovery process (please upload documents to be completed) Other Please state what other action items you need upon the subject being locatedDocuments to be Served Drop files here or Select files Max. file size: 128 MB. Documents to be Completed Drop files here or Select files Max. file size: 128 MB. Please provide a brief synopsis of the case, claimed injuries/limitations and medical treatments at issueFacilites already known to have records and/or facilities to be excluded from our searchIs there anything else you can think of that might be useful for us to know about the subject or the case?Full Name of Person(s) Being ServedPhysical Description of Person(s) Being ServedAddress for Service (If Known) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Multiple Addresses? Yes No Address 2 Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Address 3 Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Address 4 Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Documents To Be FiledMax. file size: 25 MB. File 2Max. file size: 25 MB. File 3Max. file size: 25 MB. File 4Max. file size: 25 MB. Additional Files Drop files here or Select files Max. file size: 25 MB. 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.)Documents To Be ServedMax. file size: 25 MB. File 2Max. file size: 25 MB. File 3Max. file size: 25 MB. File 4Max. file size: 25 MB. Additional Files Drop files here or Select files Max. file size: 25 MB. Please provide any background information about the subject which may be useful in helping locate and get them served (i.e. if they are being evasive, what their role in the case is, a description of prior attempts etc.).Would you like us to file the proof of service? Yes No Would you like us to advance witness fees? Yes No Upload File 1Max. file size: 25 MB. File 2Max. file size: 25 MB. File 3Max. file size: 25 MB. File 4Max. file size: 25 MB. Additional Files Drop files here or Select files Max. file size: 25 MB. Please provide a brief case history along with detailed instructions for what type of investigation you needUpload Supporting Documents Drop files here or Select files Max. file size: 128 MB. Is there a specific date this must be completed by?(Requests for completion in 2 weeks or less may incur additional fees)Information to InvestigatePlease provide a brief synopsis of the case and the key playersWhat 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?Additional Investigation Requirements Medical Canvassing Investigation Surveillance/Sub-Rosa Relevant Documents Drop files here or Select files Max. file size: 128 MB. Relevant Documents Drop files here or Select files Max. file size: 128 MB. Relevant Documents Drop files here or Select files Max. file size: 128 MB. Relevant Documents Drop files here or Select files Max. file size: 128 MB. Δ
