MFHS Evidence Collection Log - Minnesota Federated Humane Societies

EVIDENCE COLLECTION LOG

Case No.: *

Date: *

Time: *

Agent Name: *

Badge #: *

AV Name: *

AV Address: *

Line 1

Line 2

City

State

Zip Code

Country

List Animal(s): *

Photos taken of animals: *

Max file size: 20MB

The following evidence has been collected; *

Photos taken of evidence *

Max file size: 20MB

Agent signature: *

Max file size: 20MB

Date: *

Agent Notes/Office Use Only: *

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Anoka, MN 55303

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