Questions? Call: (800) 733-1950

Surveillance Services - Form not for Insurance-Related Claims.

CLIENT INFORMATION

ATTORNEY / LAW FIRM NAME/ CLIENT NAME: *

Today's Date:

CLIENT NAME / REQUESTOR NAME/ PERSON REQUESTING SERVICE:

Email Address: *

CONTACT PERSON (paralegal or associate attorney) & POSITION

REPRESENTATIVES AUTHORIZED TO SIGN FOR THE COMPANY OR FIRM:

EMAIL ADDRESS OF REPRESENTATIVES AUTHORIZED TO SIGN THE AGREEMENT:

INVOICE PROCESSING AND PAYMENT EMAIL ADDRESS:

Office Phone

Direct / Private Line

Cell Phone

LAW FIRM / CLIENT ADDRESS:

City

State/Province

Zip/Postal

Comments

Due Date

Client File# / Client Name:

Civil Case#

*RUSH ASSIGNMENT

INVESTIGATION SEARCH REQUESTED: Client Must Identify Desired Search

Checkboxes

INDIVIDUAL - Date of Birth Acquisition Fee $50.00

INDIVIDUAL - Unique Identifier (UID) Acquisition Fee $50.00

SURVEILLANCE: Hourly Rate $195.00 per hour, per investigator used. Travel Time and Mileage are not included in the hourly rate.

OTHER: Investigation Services not listed on this form. If you want another service please attach an event summary regarding the circumstances.

INDIVIDUAL'S INFORMATION (SUBJECT INFO)

SUBJECT: Name (First, Last) *

SUBJECT: Date of Birth

SUBJECT'S: Social Security Number

SUBJECT'S SPOUSE: Name (First, Last) *

SPOUSE'S: Date of Birth

SUBJECT'S MOST RECENT OR CURRENT: Address

City

State/Province

Zip/Postal

Country

SUBJECT'S: Previous Address

PROFESSIONAL OCCUPATION / EMPLOYMENT:

KNOWN VEHICLES:

Stryker Investigations does not accept checks via the U.S. Postal Service mail.

An Electronic Invoice will be emailed to you through Square or QuickBooks. Payment can be made using your credit card, Apple Pay, Google Pay, or by law firm check.

If paying with a company check, please scan a copy of both the front and back of the check and email it to Stryker.

Upload Documents

Maximum file size: 30MB

Name of Representative Authorizing Services *

Closing Comments:

We sincerely appreciate your confidence in Stryker and look forward to working with you on this assignment.

If you have any questions, please call us at (800) 733-1950

Thank you for this assignment.

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Stryker Investigation Services

1 (800) 733-1950

Surveillance Services Form