Below we have provided you with fields where you can provide us with details regarding your case that Charles Hess Investigations, Inc will need in order to provide you with service. Please note, that fields that have an asterisk (*) next to them are required information.

Your Contact Information Have you ever hired a detective before? Yes No Company/Employer: First Name*: Last Name*: Address*: Suite/Apt. City*: State*: Please Select AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington, D.C.West VirginiaWisconsinWyoming ZIP*: Phone*: - - Cell Phone: - - Fax: - - Email Address:   Best time to contact you: AM   PM Preferred Method: Phone Cell Phone    Email   Mail   Your Vehicle Information Vehicle #1 Make: Model: Color: Tag#: Year: Vehicle #2 (If applicable) Make: Model: Color: Tag#: Year: Vehicle #3 (If applicable) Make: Model: Color: Tag#: Year:   Assignment Type Service*: Please Select Missing Person Surveillance Counter-Surveillance Background Check Corporate Investigation Crime/Victim Investigation Criminal Defense Domestic Investigation Asset Search Process Service Child Custody Personal Protection Skip Tracing Pre-Employment Screening Pre-Marital Screening Record Search & Retrieval Undercover Operation Other (Please Specify) Other: (Please specify) Number of Days Requested: Please Select 1 2 3 4 5 6 7 2 Weeks 3 Weeks 4 Weeks or More (Surveillance Only) Reason for Surveillance: Relationship to Subject*: (Spouse, Friend, Employer, Creditor, etc.)   Subject's Primary Information First Name*: Last Name*: Address*: Suite/Apt.: City*: State*: Please Select AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington, D.C.West VirginiaWisconsinWyoming ZIP*: Phone: - - Cell Phone: - - Email Address: Date of Birth: Social Security Number: - - Drivers Lic. # (if available)   Workers Compensation Cases State of Loss: Date of Loss: Occupation: Please Select Automotive Community Construction Convention Corporate Correctional Education Financial Food and Beverage Government Hardware Healthcare Manufacturing Media Non-Profit Product Recreational Real Estate Retail Transportation Other Build: Please Select Small Medium Large Unknown Is claimant currently working: ----- Yes No Have previous investigations been preformed?: ----- Yes No Description of claimant's disabilities/restrictions:   Subject's Physical Description Sex*: Please Select Male Female Unknown Race*: Please Select White Black Hispanic Asian Native Hair Color*: Please Select Black Brown Blonde Red Brunette Salt/Pepper Gray Other Build*: Please Select Small Medium Large Unknown Approximate Height: ft.    in. Approximate Weight: lbs. Other Descriptive Details (tattoos, disabilities, scars, etc.): Marital Status: Please Select Single Married Co-Habiting Unknown Spouse Name:   Subject's Vehicle Information Vehicle #1 Make: Model: Color: Tag#: Year: Vehicle #2 (If applicable) Make: Model: Color: Tag#: Year: Vehicle #3 (If applicable) Make: Model: Color: Tag#: Year:   Additional Comments or Details Please include below ANY further information you know about the subject, such as the High school or college he/she attended, type of work, city or state of birth, what state or city you believe or know they live in now, professional memberships i.e. unions, accountant, dentist, locations the subject frequents, etc. EVERY detail you can give may help us expedite your investigation. Additionally, please list all details that you have on your case. For example: In a Domestic case you would list why you think your significant other is cheating. When they are cheating, Where they are cheating, etc. In a theft case you would list what was stolen, where is was stolen from and who you think took it and why.   Terms and Conditions Submitting this form does not constitute a contract or agreement that Charles Hess Investigations, Inc. will perform any services on your behalf. Once we receive your information, we will review your case and an agent will contact you by the method you have chosen above to discuss your options. All information supplied is kept strictly confidential. Certification and Affidavit: By submitting this online form, I hereby certify and affirm that the information supplied above is true and accurate to the best of my knowledge at this time. I understand that my knowingly supplying false or misleading information may result in my case being rejected and I will forfeit any and all funds that may be paid to the Agency pertaining to this case. I also understand that any decision regarding refunds is left solely to the discretion of Charles Hess Investigations, Inc. I acknowledge that payment is for the time, effort and expertise of employees of Charles Hess Investigations, Inc. and not directly for a particular result. Please Type Message: Phonetic spelling (mp3) I have read and agree to the conditions stated above: