ODP Certified Investigator Program
Witness Statement Form
Case Name
Witness Name
Title (relationship)
Work Location
Date of Interview
Reason for Interview
Case Number
Phone
Phone
Time
Home Address
Location of Interview:
Investigator
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Witness Signature
Date
Interviewer Signature
Date
Page 1 of
ODP Certified Investigator Program
Witness Statement Form (continuation page)
Case Name
Witness Name
Location of Interview
Case Number
Date of Interview ____
Time
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Witness Signature
Date
Interviewer Signature
Date
Continuation Page
of