Missing Person Presumed Dead Declaration Request Form
Use this form to request a declaration that a missing person is presumed dead and provide the case details needed for review.
Requester Information
Requester’s Full Name
*
First Name
Middle Name
Last Name
Relationship to the Missing Person
*
Please Select
Spouse
Parent
Child
Sibling
Other
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Missing Person Details
Missing Person Full Name
*
First Name
Middle Name
Last Name
Date of Birth
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Last Known Location
*
Date Last Seen / Date Reported Missing
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Declaration Request Details
Reason for Requesting Declaration
*
Case or Report Reference Number
Submit Request
Should be Empty: