Arrestee Information

Please be sure to provide accurate information

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Name

Select District

Gender

Age

Contact (Phone / Email)

Emergency Contact

Occupation

Organization/Institution

Arrested At

Arrest Location

Arrested by

Was an Arrest Warrant produced?

Reason for Arrest (Additional Details)

Does arrestee have any legal representation? (if yes, mention the name of lawyer/firm)

Thana / Detention Center

Please be sure to provide accurate information so we may be able to follow up on the status of your case

Your Name

Phone

Relation with Arrestee

Source of Information

I wish to remain anonymous