l~t ;jVt L.:VVO .LV:;j;j: l.V l:-'l"l -VOVV Ol:-'n!!~T \JUnt-'UI1.ATC PAU.t. OC\JUl1.l·.!."X Sprint Nextel legal CompBieuu::e 6480 Sprint Parkway, 2M Floor Overland Park, KS 66251 Office: (888) 877-7330 Fax: (816) 600-3100 2008-248218 Spencer W Electronic Surveillance Tech MANDATORY INFORMATION Agency cover sheet must be faxed with this form Call Sprint Corporate Security before faxing this form. Fax all requests to Sprint at 816-600-3100 Emergency Contact: 1-888-877-7330 Press Emergency Options ***PLEASE PRINT*** LAW ENFORCEMENT AGENCY (LEA) _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ ADDRESSOFLEA _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _~------PHONE NUMBER OF LEA FAX #_ _ _ _ _,.,--_ AGENT'S TITLE & Name SUPERVISOR'S NAME BADGE # SUPERVISOR'S PHONE #- - - - - , - - - I hereby certify that I have been granted authority by the above-mentioned LEA to determine and declare an exigent situation involving: cY b) c) immediate danger of death or serious bodily injury to any person; conspiratorial activities characteristic of organized crime; an immediate threat to a national security interest. Below is my description of the exigent situation that requires Sprint Nextel to respond immed iately (please include the Sprint Nextel phone number or any other relevant information): SPRINT NEXTEL PHONE NUMBER or CUSTOl\1ER NAME: EXIGENT DESCRIPTION:. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ I am requesting that Sprint Nextel provide the following service(s) (mark all that apply): Subscriber Information __ Call Detail Records (within the past week) __ Call Detail Records with cell site information (within the past week) . _ Precision Location of mobile device (GPS Location) NOTE: Law Enforcement Agent MUST call for each GPS attempt. Real-time audio interception (wiretap) * :j: - Applicable Fees apply. __ Real-time Pen Register, Trap & Trace * :j: - Applicable Fees apply. __ Other, please specify: _ _ _ _ _ _ _ _ _ __ * You must have access to CALEA delivery capability with Sprint. Pursuant to Title 18 United States Code §2518, §2701, and §3125 all electronic surveillance and location information assistance will terminate if the appropriate legal demand or customer consent is not received within 48 hours. The valid legal demand or customer consent should be faxed to Sprint/Nextel. j: *** I _________________ declare under penalty of perjury SIGNATURE that the foregoing is true and correct. Executed on: --=D:-:A-::::TE=----- 1 - 5510 - "'** z ur z Fax Server 5/24/2009 6:24:13 PM PAGE 1/001 Fax Server 585054, 5/2412009, SNG Please can 1-800-635-6840 lMMEDIATELY AFfER F.AXJ]\lG for processmg of this request. 1rIo.rTrIfT _ . . . . ,...... . . r .. r'II....,""TrI"1 - --=-=- -: -- - - - .-. --; --;:- - -: : -=- ... rrl ........ To: ""'1I'~L'"I"'T'flIIIr"..,nn.to ... T"..,.....,n lr.I~.".".'" g - - - ... - - "- ... -- - - -" ~~ ~ National Compliance Center (Phone 1-800-635-6840; Fax 1·888-938-4715) PITTSFIELD 911 01201 (Name of Agency/PSAP) From: Re: Emergency Request for Records for Wireless Number: PITTSFIELD 911 01201 received a request for emergency assistance from (Name) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (Number) _ _ _ _ _ _ _ _ _" a third party, who received a distress call from the above telephone on (date) _ _ _ _ _ _ _ _ 200 at _ _ _ _a.m.lp.m. Based upon that phone call, our PSAP, PITTSFIELD 911 01201 believes that one or more people . face immediate danger of death or serious physical injury. As such, we request that you promptly provide us with the following information so that we may render assistance to that individual (or individuals): current subscriber and billing information for the above-referenced telephone; and/or cell site or location information for the caIl placed by the above-referenced telephone to the third party. Signature: Printed Name: Title: Address City, Sate, Zip: Contact Number. Contact Facsimile: Date: , .. , :;, •. ' .. -----------------------This lonn must be filled out in its entirety. , Fax completed form to the NCC at (888) 938-471$. - 5511 - AT&TMOmUTif . "" , ' , i : • • P;' ",. .,'}'.>.:',' ".'.': .<. .: ":':- ~o:.' .,kMERGENctINFORMATI01'fREQUJ<;J1 > ~!. ::>r'~:':.:." ."\ >6;ll~o i~~i.~bip·dJbf~ ~.e~6n Wiie~ss . . ' ~~$S ~A~N: '" <> " • ",,',' " ., ", " : .:. .FAX: . . ,.~" .' ': -' '" " , '••• ' ... liE:' . ·0 . . . . .(800) 451.;5242, pr.ess ;<4". " {800) 345-6.7.20 . . .' '; ~HO:NE: . ',;', . .'..... ..:' . ,," . o·:·.·c'elhil·~I.No·. '.:' ',", 0,:"" . . 0-..,...-.-~---'-----:--- .'0 . . . . - fhe,,-:ebyci:lrtif'v ilia'];:'. . ",. : . (1).1 a law~enf~icefuent'officeioauthonzedby"'applicaDle l&wto request theioj.lo:wwgil.. .J.c~;.::..:~:.!.~7 .. , '. .;. ,(2) .Th~re ,is ,'an imro.o~jate da,)I1ger ofdes:th o'r s~rlous physical inJury'to a..person· requlrltl,gtliat th~ iuiODIl8.tion. below., 'be prpvided "vyitiiout waitiJ:lgfor.a:c6tirt.ord~r; ·and'.· '. . . ,': " " . .{3) If I am reqll:estiDg ~pen.register or ~jreta;1J surveillance, I certify that a. court~Fde(\?duJd be entlD.reo,'· . ..,' . .a.1J.t~::l.OriiID.g ~.e jllt~rceptibnrequested beJp:~T aud tba~ my .agen.cy .wi~ obtain a. court ord~~:approyjng·tb.~s -interceptiou am: 0 • 0 • • ' '. :withili 4~hourso . . : ..,'.:.. . ' : .. : ...... <....: " ':" .' .::'.. ' .. :. . . . Acc.ordingly. I r~qllest(cJjeckinJormation' requested··and sp~cmr'tinie'fnime for·.~~hich it is requested); "':,' ':, . '. '. . . . " " '," " " '..... '. Type, of ", '0' . 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