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Homeright arrowDeath in Custody Forms

Overview

The federal reporting form currently used for individual case reporting is available at right. This PDF file may be printed and used for reference, or submitted to SAC in part or in full when a case occurs, if that is convenient. Generally the first page of the incident level case Addendum form is completed from death certificate information, and the second page from law enforcement agency information. A second, Quarterly Summary Form also is available at right. This form is primarily SAC's quarterly reporting cover page; however, it contains definitional information that may be of interest.

If users or contributors have questions about this reporting system, wish to notify SAC of a possible case, or submit a form on a known case, please contact the SAC Unit.

Forms

Quarterly Summary of Deaths in Law Enforcement Custody:

  • 20_CJ11 (Format: Adobe PDF Icon (pdf), Size: 452KB)

Law Enforcement Custodial Death Report Form
(Use this form if your agency has any death in custody to report)

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