Online investigation order form - surveillance - The Australian Research Investigation Agency - Austresearch- is based in Northern New South Wales, Australia, servicing Northern New England from Armidale to the Northern Rivers, Lismore Coast, Southern Queensland and along NSW and Queensland border from Texas to the Gold Coast.

Australian Research and Investigation Agency


	Online Order Surveillance

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Service order form - Surveillance

Please complete this form. Where a requested input is not relevant or information is not know, please write "n.a." and do not leave any inputs empty. Our investigation will be based on the information you supply and authorise. The more comprehensive and accurate the information, the greater the prospect of success.

Name
Business/company name
Business address
Contact name
Contact's phone number
Contact's mobile numer
Contact's fax number
Contact email
Retype email
Type of matter for which surveillance is required
Your reference
Claim number
Date of injury or event
Nature of injury or event (for new paragraph hit enter twice)
The Subject (to be observed)
Gender	Male Female
First Name
Surname
Address
Other known addresses
Telephone
Email
DOB
Driver Licence #
Alias
Place of birth
Nationality
Ethnic background
Occupation
Employer (current)
Is this employer your insured?	Yes / No
Employer's Address
If not your insured, name of your insured
Insured's address
Employer (previous)
Employer address (previous)
Has the subject been investigated previously?	Yes No
If YES, some details please
Description of subject
Height
Build
Hair
Distinguishing features
List vehicle make, model, colour and registration number(s)
Is a medical appointment pending? Give details
Please explain the circumstances of your decision to investigate
Surveillance Requirements
Total hours
	To include travel time? Yes No
Number of days
Preferable days
Video?	Yes No
Photos?	Yes No
Due date of report
If report to be addressed to your legal representatives, please identify your lawyers
You can upload documents or images that may assist us in your selection. Note: "bad" or hostile files/programs will be blocked
Attach document/file #1

Attach document/file #2

Attach document/file #3

Reporting preferences Please tick your choice of reporting format
Reports & digital photographs	on CD ROM
	on DVD
	on USB Removable Storage
	by email
	Hard copy by Registered Post
	by Courier Delivery
Documents, video & digital photographs Hard copy	by Registered Post by Courier Delivery
Payment - what method of payment will you be using for our services
Please select

Additional service forms:

Factual investigations»

Research»

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Payment Information»