Armed Forces Autopsy Report Request Mobile App

Included Fields

Customize to add, remove, or edit any of the fields below.

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  DATA REQUIRED BY THE PRIVACY ACT OF 1974

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  Authority: Title 10 USC, Section 1471

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  Principal Purpose: To obtain records/reports/photos of remains by persons legally authorized acce...

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  Routine Uses: By Department of Defense and other agencies to document and authorize actions neces...

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  Disclosure: Disclosure of requested information is voluntary.

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  NAME OF DECEASED (Last, First, Middle Initial)

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  SERVICE / RANK OF DECEASED

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  SSN OF DECEASED

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  NAME OF REQUESTOR

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  RELATIONSHIP TO DECEASED / REASON FOR NEED TO KNOW

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  REQUESTOR DAYTIME PHONE NUMBER(S)

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  REQUESTOR EMAIL

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  FOR OAFME USE: RECEIPT DATE

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  INITIALS

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  I, the undersigned, am requesting to receive a copy of the official autopsy report written and ma...

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  I wish to receive the following (select one or both):

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  I would like to receive a copy of the official autopsy report written by the Office of the Armed ...

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  I would like to receive the photographs taken by the Office of the Armed Forces Medical Examinerd...

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  I understand official federal business requests will be sent via a secure DoD file sharing system...

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  Please send the requested information to the following (select one):

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  Official Business Request.

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  OFFICIAL GOVERNMENT EMAIL (MANDATOR

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  Please deliver the requested material to my home address:

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  SHIPMENT ADDRESS (NOTE: FEDEX DOES NOT DELIVER TO P.

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  Please deliver the requested material to the following individual on my behalf:

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  NAME OF ADDRESSEE

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  ADDRESSEE DAYTIME PHONE NUMBER(S)

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  SHIPMENT ADDRESS (NOTE: FEDEX DOES NOT DELIVER TO P.

• ...and More!