Phoenix Research, Inc.
P.O. Box 589, Mt. Orab, OH 45154-0589
                                       Phone: 800-260-1092   Fax: 800-260-3997                                       
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Criminal Information For:                                                                                                 Today's Date:______________

Name:                                                                                                                              Client Ref #:                              

SSN:                                                                                                          DOB:                                

Search Conducted in:                                                                               State:                                            

Subject Identified by Matching:    NAME     SSN     DOB     ADDRESS     OTHER     (Circle appropriate)

List Other:                                                                                                                                                                          

Case Number:                                                                                            Violation Date / Indicted / Filed:                       

Charge / Count 1:                                                                   Convicted of:                                                 Felony  Misd.

Charge / Count 2:                                                                   Convicted of:                                                 Felony  Misd.

Charge / Count 3:                                                                   Convicted of:                                                 Felony  Misd.

Charge / Count 4:                                                                   Convicted of:                                                 Felony  Misd.

Charge / Count 5:                                                                   Convicted of:                                                 Felony  Misd.

Charge / Count 6:                                                                   Convicted of:                                                 Felony  Misd.

Disposition / Adjudication:    Guilty    Not Guilty    No Contest    Dismissed    Withdrawn    Adjudication withheld
(circle appropriate)
Fine Amount:                               Restitution:                                Court Costs:                       Dispo Date:                      

                                                                                                                                                                                         
                                                                                                                                                                                         
                                                                                                                                                                                         
                                                                                                                                                                                         
                                                                                                                                                                                         
                                                                                                                                                                                         
                                                                                                                                                                                         
                                                                                                                                                                                         
                                                                                                                                                                                         
Additional Information:                                                                                                                                                     
                                                                                                                                                                                         
                                                                                                                                                                                         
                                                                                                                                                                                         
Phoenix Research exercises reasonable care in providing information to our clients. However, the ultimate responsibility for maintaining the accuracy of the information provided lies with the government agency from which this information is extracted. Phoenix Research accepts no liability for Errors/Omissions beyond the exercise of reasonable care.
Text Content Copyright 1999, All rights reserved. Phoenix Research Inc.