SOUTHWESTERN

INSTITUTE OF FORENSIC SCIENCES

AT DALLAS

TELEPHONE: 214-920-5964
FAX: 214-920-5812

5230 Medical Center Drive

Dallas, Texas 75235-0728

Criminal Investigation Laboratory

DRUG ANALYSIS LABORATORY

NOTICE OF MARIHUANA CORE SAMPLE
FL#____________________
Requesting Agency: DALLAS POLICE DEPT.

Agency Service # ___________________

Case Name(s):____________________________________

Tag # ____________________________

Date Requested:___________________________________
Item(s) Description:

________sealed cardboard box(es)

________sealed brown paper bag(s)

________Other: _____________________________________________________________

Balance Check: Certified Weight: __________ Actual Weight: ___________ Difference: +/- _______
Balance Check: Certified Weight: __________ Actual Weight: ___________ Difference: +/- _______
Property Room Transfer
Property Room Representative: ___________________
Date/Time Released: ____________________________
Receiving IFS Chemist: _________________________
Date/Time Returned: ___________________________
Returned To: _________________________________