How did you hear about us? Select One... GetIt Magazine Newspaper Article De Rebus Facebook Twitter Google Search Referral Other Where will the investigation take place?* Select one... KwaZulu-Natal Mpumalanga Limpopo Gauteng North West Free State Northern Cape Eastern Cape Western Cape Outside South Africa If Outside South Africa, where? Type of investigation Select one... Background Investigation Civil Court Action Criminal Case Criminal Defense Cyber-Crime Digital Forensics Domestic / Marital Due Diligence General Investigation Intellectual Property Internal Business Theft Personal Injury Post Conviction Suspicious Death Tenant Screening Debtor Trace Asset Search Corporate Espionage Undercover Investigators Other If type of investigation above is other, please elaborate Scope of Work to be Done. Be precise as this is what will appear on the agreement. (This field is mandatory) * Is this investigation required to be covert or overt (Covert=the person being investigated must not be aware of the investigation | Overt=The person being investigated can be aware of the investigation)* Select one... Covert Overt Does not matter either way Business Name * Business Building Name - (if applicable) Business Address * Business Suite Number - (if applicable) Business City * Business Province Select one.... KZN WC NC EC NP FS MP GP FS Outside of South Africa Province / State if Outside of South Africa Postal Code Country Office Phone Number Office Email Address Contact Person * Contact Person Title / Position Contact Person Phone Number Contact Person Cell Phone Number Contact Person Email Address (This is the email address that will be used for all reports and communication)* Name of the Person Signing the Contract Has a case been opened with police?* Select one... Yes No Police Case Number - (if applicable) Police Station Where Case Opened - (if applicable) Police Investigating Officer Name - (if applicable) Police Investigating Officer Phone Number - (if applicable) Police Investigating Officer Email Address - (if applicable) Have you engaged an attorney? Select one... Yes No Attorney Firm Name - (if applicable) Attorney Name - (if applicable) Attorney Firm Address - (if applicable) Attorney Email Address - (if applicable) Attorney Phone Number - (if applicable)

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