This document is for internal use only by National Central Bureaus and judicial authorities. It should on no account be submitted to the General Secretariat to request the publication of a notice.

IDENTITY PARTICULARS

Family name:

Family name in the original script or Chinese Telegraphic Code:

Family name at birth:

Forename:

Forename in the original script or Chinese Telegraphic Code:

Sex:

*Date and place of birth

Date:

Town/Region:

Country:

Nationality / Confirmed

Caution

Amnesic
Armed
Dangerous
Depressive
Addicted to drugs
Escape Risk
Mentally Ill
Infectious
This person is liable to commit sexual offences involving minors
This person is liable to use pictures of minors for pornographic purposes for his own gain
Suicidal
Under medical treatment
Violent
Other

Alias

Also known as

Family name / Forename / Date of Birth / Town/Region / Country

Nicknames

DetaILS

Marital status:

Father's family name and forenames

Family name:

Forename:

Mother's maiden name and forenames

Family name:

Forename:

Occupation:

Languages spoken:

Regions/Countries likely to be visited

Country / Region

Additional information:

Identity documents

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Nationality / .
Type
Number
Date of issue
Expiry date
Country of issue
Town of issue

IDENTIFICATION MATERIAL

Photographs

Fingerprints

DNA

Dental information

Blood group:

Clothing:

Jewellery:

Other personal effects:

PHYSICAL DESCRIPTION

Height (cm):

Weight (kg):

Hair:

Eyes:

Build:

Distinguishing marks and characteristics:

CASE

Facts of the case
Date:

Town:

Country:

Offence code(s):

Summary: { maximum 1000 characters (200 words)}

Additional facts of the case:

FUGITIVE WANTED TO SERVE A SENTENCE

CONVICTION/SENTENCE
Charge(s) on which convicted / .
Law covering the offence(s)
Sentence imposed
Remainder of sentence to be served
Time limit for enforcement
Number
Date issuance
Issuing or competent judicial authorities
In (Place+ Country)
Was the subject present in court when the judgment was rendered?
The subject has or will have the opportunity to have the case retried in his/her presence.
The subject had sufficient notice of the trial or the opportunity to arrange for his/her defence.
Name of signatory
Arrest warrant or judicial decision ordering execution of the sentence/European arrest warrant
Number
Date issuance
Issuing or competent judicial authorities
In (Place+ Country)
Name of signatory

FUGITIVE WANTED FOR PROSECUTION

ARREST WARRANT OR JUDICIAL DECISION HAVING THE SAME EFFECT / EUROPEAN ARREST WARRANT
Charge(s): / .
Law covering the offence(s)
Maximum penalty
Time limit for prosecution or expiry date of arrest warrant or judicial information having the same effect
Number
Date issuance
Issuing or competent judicial authorities and place of issuance:
In(Place + Country)
Name of signatory

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CONFIDENTIAL INTENDED ONLY FOR POLICE AND JUDICIAL AUTHORITIES