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If a chain of custody record is required in your situation, you may
use your own form, request that we fax you a form, or print out a chain
or custody record from your browser. Please follow these instructions when
filling out a chain of custody record:
 | Please type or print clearly. |
 | Please include the COURIER (UPS, Federal
Express, hand delivered, etc.), METHOD OF SHIPMENT (Next Day
Air, Ground, Priority Overnight, etc.), and TRACKING NUMBER in
the spaces provided. |
 | Include the SAMPLE ID on the form. The
Sample ID should include the Claimant's Name, Claim Number,
& Date of Loss. (ex. Thomas Q. Public, Claim # 1234567,
1/1/00; object from cheeseburger). |
 | Include the SAMPLE DESCRIPTION on the form.
The Sample Description should include the physical description
of the actual components included. (ex. hard object and
cheeseburger (in wrapper) inside a plastic bag). |
 | Label the page numbers at the top of each page. |
Click here to link to the Chain of
Custody Record
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