Your group name here



?????  respects your right to privacy.  All of your personal information will be kept confidential.  ????? would like to use some or all of the information and evidence collected during the investigation for possible inclusion in our website, newsletter and other future media considerations.  Please check the level of confidentiality you would like to request:

___ ????? may release the information providing that the identity of witnesses and clients are changed and the exact address of the location is excluded.

___ ????? may release any/all of the information and evidence collected during the investigation.

___ Other comments/requests____________________________________________________________________________________________


Signed___________________________     Date___________
Witness__________________________     Date___________
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