- 5510 -

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Transcription

- 5510 -
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Sprint Nextel legal CompBieuu::e
6480 Sprint Parkway, 2M Floor
Overland Park, KS 66251
Office: (888) 877-7330
Fax: (816) 600-3100
2008-248218
Spencer W
Electronic Surveillance Tech
MANDATORY INFORMATION
Agency cover sheet must be faxed with this form
Call Sprint Corporate Security before faxing this form.
Fax all requests to Sprint at 816-600-3100
Emergency Contact: 1-888-877-7330 Press Emergency Options
***PLEASE PRINT***
LAW ENFORCEMENT AGENCY (LEA) _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
ADDRESSOFLEA _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _~------PHONE NUMBER OF LEA
FAX #_ _ _ _ _,.,--_
AGENT'S TITLE & Name
SUPERVISOR'S NAME
BADGE #
SUPERVISOR'S PHONE #- - - - - , - - -
I hereby certify that I have been granted authority by the above-mentioned LEA to
determine and declare an exigent situation involving:
cY
b)
c)
immediate danger of death or serious bodily injury to any person;
conspiratorial activities characteristic of organized crime;
an immediate threat to a national security interest.
Below is my description of the exigent situation that requires Sprint Nextel to
respond immed iately (please include the Sprint Nextel phone number or any
other relevant information):
SPRINT NEXTEL PHONE NUMBER or CUSTOl\1ER NAME:
EXIGENT DESCRIPTION:. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
I am requesting that Sprint Nextel provide the following service(s) (mark all that apply):
Subscriber Information
__ Call Detail Records (within the past week)
__ Call Detail Records with cell site information (within the past week)
. _ Precision Location of mobile device (GPS Location)
NOTE: Law Enforcement Agent MUST call for each GPS attempt.
Real-time audio interception (wiretap) * :j: - Applicable Fees apply.
__ Real-time Pen Register, Trap & Trace * :j: - Applicable Fees apply.
__ Other, please specify: _ _ _ _ _ _ _ _ _ __
* You must have access to
CALEA delivery capability with Sprint.
Pursuant to Title 18 United States Code §2518, §2701, and §3125 all electronic surveillance and
location information assistance will terminate if the appropriate legal demand or customer consent is not
received within 48 hours. The valid legal demand or customer consent should be faxed to Sprint/Nextel.
j:
*** I _________________ declare under penalty of
perjury
SIGNATURE
that the foregoing is true and correct. Executed on:
--=D:-:A-::::TE=-----
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Fax Server
5/24/2009 6:24:13 PM
PAGE
1/001
Fax Server
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Please can 1-800-635-6840 lMMEDIATELY AFfER F.AXJ]\lG for processmg of this request.
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- --=-=- -: -- - - - .-. --; --;:- - -: : -=-
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To:
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National Compliance Center
(Phone 1-800-635-6840; Fax 1·888-938-4715)
PITTSFIELD 911 01201
(Name of Agency/PSAP)
From:
Re:
Emergency Request for Records for Wireless Number:
PITTSFIELD 911 01201 received a request for emergency assistance from (Name)
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (Number) _ _ _ _ _ _ _ _ _" a third
party, who received a distress call from the above telephone on (date) _ _ _ _ _ _ _ _ 200
at
_ _ _ _a.m.lp.m. Based upon that phone call, our PSAP, PITTSFIELD 911 01201 believes that one or more people
. face immediate danger of death or serious physical injury. As such, we request that you promptly provide us with the
following information so that we may render assistance to that individual (or individuals):
current subscriber and billing information for the above-referenced telephone;
and/or
cell site or location information for the caIl placed by the above-referenced telephone to the third party.
Signature:
Printed Name:
Title:
Address
City, Sate, Zip:
Contact Number.
Contact Facsimile:
Date:
, .. , :;, •.
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-----------------------This lonn must be filled out in its entirety. ,
Fax completed form to the NCC at (888) 938-471$.
- 5511 -
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.{3) If I am reqll:estiDg ~pen.register or ~jreta;1J surveillance, I certify that a. court~Fde(\?duJd be entlD.reo,'·
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