Eclipse Government • self-background-check

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self-background-check

Posted: 26 Aug 2025, 13:29

by 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

Re: self-background-check

Posted: 26 Aug 2025, 21:24

by Zoey Deul

Los Santos Police Department
"TO PROTECT AND TO SERVE"

Re: Personal Background Check

Adam Cougzy,

The requested information has been forwarded to your email.

Respectfully,
Police Detective III Zoey Deul
Los Santos Police Department