SOUTH CAROLINA AMBER ALERT INFORMATION FORM

SOUTH CAROLINA LAW ENFORCEMENT DIVISION

Fax (803) 896-7041 (If problems, call (803) 737-9000) or (800) 322-4453)

*IMPORTANT: Do NOT send an AMBER Alert if the answer is NO to ANY of these questions.

Does the law enforcement agency believe that the child has been abducted (taken from their environment unlawfully, without authority of law, and without permission from the child's parent or legal guardian)?							Reporting Agency Information: Name of Reporting Agency:
If the child is 17 years old or younger, does the law enforcement agency believe the child is in immediate danger of serious bodily harm or death, or if the individual is 18 years old or older, does the law enforcement agency believe the individual is at greater risk for immediate danger of serious bodily harm or death because the individual possesses a proven physical or mental disability?							Name/Title of Reporting Individual: Contact Number for Reporting Agency
Have all other possibilities for the victim’s disappearance been reasonably excluded?							NCIC Number
Is there sufficient information available to disseminate to the public that could assist in locating the victim, suspect, or vehicle used in the abduction?
Date of Abduction:  _______________					Time of  Abduction:________________________________
Last Known Location:  __________________________________________________________________
(Address/City/State) Direction of Travel:  _____________________________________________________________________ ______________________________________________________________________________________
VICTIM DATA: (Please email a photograph of the victim to od1@sled.sc.gov, if available)
Victim Name (First/Middle/Last):____________________________________________________________ (IF MORE THAN ONE VICTIM, INCLUDE ON ADDITIONAL PAGE WITH SAME INFORMATION)
Age:_____	DOB:________		Wt:  ______			Ht. _______		Race:_______	Sex:________
Eyes: ______		Eyewear:___________		Hair/Hairstyle:_______________________________________
Clothing:______________________________________________________________________________
Unique physical characteristics/additional Information:____________________________________________________________________________

SUSPECT DATA: (Please email photograph of the suspect to od1@sled.sc.gov, if available)
Suspect  Name (First/Middle/Last):________________________________________________________ (IF MORE THAN ONE SUSPECT, INCLUDE ON ADDITIONAL PAGE WITH SAME INFORMATION)
Age:_________	DOB:_____	Wt:____		Ht:________	Race:__________	Sex:________
Eyes:_________	Eyewear:  _________		Hair/Hairstyle:_____________________________________________
Clothing:______________________________________________________________________________
Unique physical characteristics/additional information:_________________________________________________________________________

VEHICLE DATA:
Make: _________	Model:  _____________		Year:  ________	Color:  __________________
Tag:  *	State:_______	Description:_________________________________________

* Please make sure tag information is legible.

Created By:_______________________________

10/24/06:gdb