Sample Evid. Sub. Form
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Sample Evidence Submission Form (ESF)

Sample Evidence Submission Form (ESF)

State of Minnesota

Department of Law and Public Safety

Division of  State Police

Request for Examination of Evidence

Crime:      Burglary                                 In the County of:       Hennepin

Lab No:   091105-1               Submitting Agency:  WHS Forensics Unit

Victim:   Eric Nettime                 Suspect:   Joe Barnell

Forward Replies to:  Capt. C. Salokar

Investigated by:   Sgt. J. Linn                     Delivered by:   P. Qapmoc

Brief History of Case:   Door forced open with blunt instrument.  Laptop equipment removed from locked cupboard, also forced open with blunt instrument.  Suspect found in hall, unable to bend to pick up dropped ethernet cord.  Search revealed crowbar in back of jacket.  Backpack found in garbage can around corner from suspect's position.  Backpack contained laptop and hardware.

Examinations Requested:

1.  Comparison, end of specimen 1 with marks on 8 & 9.

2.  Comparison, specimen 5 with 6 & 7.

3.  Determination of marks on specimen 3 consistent with marks on 4

List of Specimens:

1.  One (1) twelve in crowbar -- suspect's

2.   One (ethernet cord)

3. One laptop with cord, CD drive, USB adapter

4. Blood --smear collected from suspect

5  Blood -- smear collected from crowbar

6. Blood -- smear collected from cupboard door

7. Tool marks on main door

8. Tool marks on cupboard

Note:  Photos of above scene to be forwarded to Cpt. C. Salokar