ATLANTA POLICE DEPARTMENT

Confidential Source History Sheet

CS #
Code Name or #

Name	Signature

Alias:	Signature

Telephone #:	DOB:	Age

Address:

Race:	Sex: Male Female Height	Weight

Eye color:	Hair color/ style	Marital Status

SSN:	Driver’s License #

Identifying scars, marks or tattoos:

Emergency Contact Person:	Phone #

Address:

Other Information:

Occupation	Employer
Address	Phone
Income	Associates
Idiosyncrasies
An individualizing characteristic or quality
Languages Spoken
Attitude toward law enforcement
Past or present CS experience
Places Frequented
Past or present gang affiliation
Attached:	Fingerprint	Current photograph	Current criminal history	Open criminal case
Controlling Officer:
Please Print Name
APD ID #
Assignment
Signature
Date

Supervisor:
Please Print Name
Signature
Date

Section Commander:
Please Print Name
Signature
Date

Approved	Disapproved
SES Commander
Please Print Name
Signature
Date
APD Form 344 revised 6/12/07

CONFIDENTIAL

ATLANTA POLICE DEPARTMENT

AJordan

2007-07-03

VLivsey

Atlanta Police Department