IFRS REPOSITORY SUBMISSION FORM
City __________________________ State ___________________ Zip Code _______________
Telephone ____________________________ Email ____________________________________
Information being submitted
Please describe the information for which you wish to obtain a case number:
Please submit only photographic representations of material objects!
Please submit complete descriptions of the particular case you are investigating.
Include time, date, persons involved, location etc...:
Please attach your information to this submission form
Are you the principal investigator
(circle one) YES NO
Do you certify that you are the rightful owner of any evidence that is being submitted (circle one) YES NO
Do you certify that all information submitted by you is true (circle one) YES NO
I swear that I am responsible for any misrepresentation of material/information submitted to the IFRS Repository.
I hold the IFRS blameless and understand that any legal repercussion of my falsification is solely mine.
I submit this information in good faith under the prevailing laws of the UNITED STATES, its' subject states and
municipalities. I understand that the IFRS honors all applicable laws.
Mail to: IFRS Repository P.O. Box 411 Griffin, GA 30224-0411
Your case number is ________________________________________________.