Have You Been Victimized by an "Escape From Justice?"

If you have been touched by a case where the perpetrator has escaped justice in the United States, please fill out the form below. By answering a few simple questions, we may be able to assist you. Thank you.
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Your Name and Contact Information:

Last Name:                   First Name:                   Middle Initial: 
E-Mail Address:                    
Street Address 1: 
Street Address 2: 
City:   State:   Zip Code:
Day Phone:   Night Phone:
Your relationship to the case: (i.e. victim, relative, friend) 
What is the name of the perpetrator:  
Alias/Monikers, etc. 

Physical description of the perpetrator (if known)

        a. Height:                 f. Hair Color: 
        b. Weight:                g. Tattoos:      
        c. Date of Birth:           h. Other:         
        d. Ethnicity:              i.  SSN  :          
        e. Eye Color:  

Describe the crime that was committed:

What police agency investigated the case
(including the names of the investigators, if known):

Was a criminal case filed?
(Include the case number, prosecutor and prosecuting agency, if known):

To what country do you believe the perpetrator has fled:

Why do you believe that the perpetrator has fled the country?

Fugitive's address or location (if known):

Any other information you would like us to know:

Please click the submit button only once!

You will see a confirmation notice after a short delay.

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