Submission Method In Person Drop Box Mail/Certified
Other
DPS Laboratory Use Only DPS Laboratory Case #
Complete the following for in person submissions only:
Printed Name (of submitting individual)	Agency
Signature	Date

New Service Request

Additional Evidence	Resubmission	Corrected Copy

DPS Lab Case # (if known)
Submission Information
Agency
Agency Case #
Offense
Offense Date
Offense County
Agency Contact Information
Title / Badge #

Full Name
Agency Address	City, State, Zip
Mark if new address
Business Email	Phone	Fax
Contact Info for Additional Report Distribution:

Individual (S = Suspect, V = Victim, E = Elimination)

Name (Last, First, Middle, Suffix)	S / V / E	Race	Sex	DOB

Description of Evidence Submitted	(Attach Incident Synopsis or Offense Report)

Agency Item #	Brief Description of Evidence [Indicate any information relevant to evidence testing]	Includes	Quantity	Source	Request Code(s)
Biohazards Sharps Lithium Batteries
Biohazards Sharps Lithium Batteries
Biohazards Sharps Lithium Batteries

Laboratory Service Request Codes	(Enter selected codes in the “Request Code(s)” column)

AF	AFIS	SD	Seized Drugs (Identification)	TE	Trace Evidence
FR	Friction Ridge (Latents)	SDQ	Seized Drugs (Quantitation – Federal Only)	IMP	Impressions
DNA	Biology/DNA	FA	Firearms	pGSR	Primer Gunshot Residue
FDE	Forensic Document Examination	FAS	Firearms (Serial Number)	ILR	Ignitable Liquid Residue
DMD	Digital/Multimedia (Computer / Mobile / Vehicle)	FAD	Firearms (Distance)	Ignitable Liquid Residue Can QC Check – Lot #:
DM	Digital/Multimedia (Video / Audio / Image)	TM	Toolmarks

Description of Evidence Submitted	(Attach Incident Synopsis or Offense Report)

Agency Item #	Brief Description of Evidence [Indicate any information relevant to evidence testing]	Includes	Quantity	Source	Request Code(s)
Biohazards Sharps Lithium Batteries
Biohazards Sharps Lithium Batteries
Biohazards Sharps Lithium Batteries
Biohazards Sharps Lithium Batteries
Biohazards Sharps Lithium Batteries
Biohazards Sharps Lithium Batteries
Biohazards Sharps Lithium Batteries
Biohazards Sharps Lithium Batteries
Biohazards Sharps Lithium Batteries

Laboratory Service Request Codes	(Enter selected codes in the “Request Code(s)” column)

AF	AFIS	SD	Seized Drugs (Identification)	TE	Trace Evidence
FR	Friction Ridge (Latents)	SDQ	Seized Drugs (Quantitation – Federal Only)	IMP	Impressions
DNA	Biology/DNA	FA	Firearms	pGSR	Primer Gunshot Residue
FDE	Forensic Document Examination	FAS	Firearms (Serial Number)	ILR	Ignitable Liquid Residue
DMD	Digital/Multimedia (Computer / Mobile / Vehicle)	FAD	Firearms (Distance)	Ignitable Liquid Residue Can QC Check – Lot #:
DM	Digital/Multimedia (Video / Audio / Image)	TM	Toolmarks