Customs Officer Record Verification Request
Submit a request to verify the record of a customs officer. Please complete all sections accurately to ensure prompt processing.
Full Name of Requestor
*
First Name
Last Name
Requestor's Email Address
*
example@example.com
Requestor's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Organization/Company Name
*
Officer's Full Name
*
First Name
Last Name
Officer's Badge/Employee Number (Last 4 Digits Only)
*
Department or Office
*
Purpose of Verification
*
Type of Verification Requested
*
Employment Status
Service Record
Disciplinary Record
Other
Date of Request
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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Additional Details or Comments
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