Suspicious Call Log
Submitted by:
*
First Name
Last Name
Email
email@vikingchemical.com
SUSPICIOUS CALL DETAILS
Date Call Received
-
Month
-
Day
Year
Date
Time Call Received
Hour Minutes
AM
PM
AM/PM Option
Name of Caller
First Name
Last Name
Phone Number of Caller
Company Name (if applicable)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Suspicious Call Checklist
DEA Chemicals or Chemicals of Interest
Payment Method: Cash or Personal Check
Delivery Method: Customer Pick-Up
Delivery Address: Residential Area
Explain Why You Think The Call Was Suspicious
NOTE: List Chemicals/Products, Caller's Comments/Questions, etc.
Detailed Description
Ex.: Description of Voice/Accent/Speech, Estimated Age, Call Duration, Background Noises
Signature
#A-34 Revised: November 2019
Submit
Should be Empty: