self-background-check

[dhaker12]

A. PERSONAL INFORMATION

• A.1 - Full Name:
  • Adam Cougzy
  A.2 - Phone Number:
  • 3842272
  A.3 - Gov. License (Example):
  • ATTACHED DOCUMENT
  A.4 - Passport Photo (Example):
  Photo should be of the front of your face, with your shoulders visible. No hats, glasses or any facial obstruction are permitted.
  • ATTACHED DOCUMENT

B. REQUEST OPTIONS

• B.1 - Timeframe:
  Mark only one box by changing [cb] to [cbc]
  • One week
    Two weeks
    Three weeks
  B.2 - Relevant Offenses:
  Mark up to three boxes by changing [cb] to [cbc]
  • Citations
    Misdemeanors
    Felonies

C. ACKNOWLEDGEMENT

• I, the undersigned, affirm under penalty of forgery, that all information provided above is accurate, to the best of my knowledge, and has not been on filed on behalf of another person, entity or organization.
  
  C1. Signature: Adam Cougzy
  C2. Date Signed: 26/AUG/2025

[Zoey Deul]

Los Santos Police Department "TO PROTECT AND TO SERVE"

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• Re: Personal Background Check
  
  Adam Cougzy,
  
  The requested information has been forwarded to your email.

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• Respectfully,
  Police Detective III Zoey Deul
  Los Santos Police Department