PROXIMA BETA – LAW ENFORCEMENT DATA REQueST GUIDELINES

- LEGAL PROCESS REQUEST / PRESERVATION REQUEST FORM

Please use this form only if you are a Requesting Authority making a Request in accordance with the PROXIMA BETA Law Enforcement Data Request Guidelines.

Requested Game:

Requesting Authority:

Request Contact’s Details:

(i) Requesting Authority

(ii) Agent Name and Rank

(iii) Badge/Identification Number:

(iv) E-mail Address (must be from the Requesting Authority’s email domain address):

(v) Direct phone number

(vi) Address

Detailed description of the Request, including the relationship of the Request (and the data being requested) to the relevant law enforcement investigation:

The user to which the Request relates (including their identification / IP address/ account details):

List and specific type of data being requested.

Purpose for which each type of requested data is to be used in relation to the Request.

Why is the requested type of data considered necessary for the identified purpose(s).

The basis of the Request, including the provisions of any specific legislation being relied upon and relevant supporting documentation evidencing authorisation to make such Request.

(Proposed) Request response date:

I declare that to the best of my knowledge, all information contained in this Request Form is true and correct. The order / warrant / direction is attached to this form / I declare that I intend to take all necessary steps to apply for valid legal authority and I undertake to provide to you forthwith a copy of any valid legal authority obtained or confirmation that the Preservation Request be released, as the case may be, pending the outcome of the relevant application.

_____________________________ _________________________________________________________

Signature and identification number Date