Cox Communications, Inc.Lawful Intercept Worksheet
Please complete with all relevant information and fax with each court order to404-269-1898
Surveillance Order: (Attach)
Date of Order ______________________________________________________Date Served ______________________________________________________Termination Date ______________________________________________________Case/Docket# ______________________________________________________
New or Extension? ______________________________________________________Deactivation? ______________________________________________________
Target Information:
Name(s) ______________________________________________________Phone ______________________________________________________IP Address ______________________________________________________Email Address ______________________________________________________Physical Address ______________________________________________________MAC Address ______________________________________________________Other ______________________________________________________
LEA Information:
Agent/Officer ______________________________________________________Agency ______________________________________________________Case Agent ______________________________________________________Contact Info. ______________________________________________________Technical Contact ______________________________________________________Contact Info. ______________________________________________________Agency ______________________________________________________Billing Contact ______________________________________________________Billing Address ______________________________________________________Billing Ref. No. ______________________________________________________
Surveillance Type
: Phone Pen/TrapWiretap/Title IIIFISACellular Pen/TrapWiretap/Title IIIFISALocationBroadband Non-ContentData to Capture:E.g. Email Header logsDHCP/IP RecordsSubscriber InfoInternet Traffic______________________________________________________________________________________________________________________________________________________ContentContent to Capture:E.g. Email content______________________________________________________________________________________________________________________________________________________
LEA Technical Requests:__________________________________________________________________________________________________Note:
If intercept is through Neustar, VPN setup may be required.
See attached Notice for contact, billing and service of process details.Please fax a signed copy to: (404) 269-1898After business hours, fax to Eastern Time Zone: (877) 866-4474
