Mississippi Amber Alert System

Initial Reporting Form

AMBER ALERT ACTIVATION CRITERIA CHECKLIST

1. Do you believe a child has been ABDUCTED?
____ If Yes, go to question 2
____ If No, DO NOT INITIATE AN AMBER ALERT

2. Is the abduction one in which the child is 17 years of age or younger?

____ If YES, answer question 3
____ If No, DO NOT INITIATE AN AMBER ALERT.

3. Did the abduction involve acts of violence?

____ If Yes, answer question 5.
____ If No, answer question 4.

4. Do you believe the child to be in danger of serious bodily harm or death?

____ If Yes, answer question 5.
____ If No, DO NOT INITIATE AN AMBER ALERT.

5. Is their adequate descriptive information available to believe that its dissemination to the public could help
locate the child, suspect, or suspect vehicle?
____ If Yes, ACTIVATE THE AMBER ALERT.
____ If No, DO NOT INITIATE AN AMBER ALERT.

The alert must contain a description and photograph of the child, a description of the suspect or suspect vehicle, as
well as the details of the abduction. Law enforcement should carefully consider not initiating an alert if there is not
specific information for the public to use to assist in the recovery. Do not use an Amber Alert for runaways or
parental abductions unless the child is in danger of serious bodily harm or death. The requesting Law Enforcement
agency must complete the attached form, provide a photograph of the child and enter the child on NCIC prior to MHP
issuing an Amber Alert.

IF ANY OF THESE CRITERIA ARE NOT MET, MHP HAS AN

ENDANGERED/MISSING CHILD ALERT THAT CAN BE ACTIVATED INSTEAD
OF THE AMBER ALERT.

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 Mississippi Amber Alert System
Initial Reporting Form
Section I Identification/Time/Location
Full Name of Missing Child:
INFORMATION REGARDING LAST SIGHTING OF MISSING CHILD:
City or Community:
County:
Day and Date: Exact time:
Exact Address:
Landmarks near last sighting:

Last known direction of travel (include Hwy and/or street name):

Section II Threat of Imminent Danger

Is the missing child believed to be in imminent danger?
Is there evidence the child was abducted?
Section III Personal Information & Description
Race/Ethnicity of missing child: male/female:
Color and style of hair: Eye color:
DOB: Complexion: Ht: Wt:
Description of clothing child was last seen wearing (include personal items child may have had in possession):

Section IV Supplemental
Name and DOB of individual who may be with missing child:___________________________________________
_____________________________________________________________________________________________
Description of individual who may be with missing child:_______________________________________________
_____________________________________________________________________________________________
Description of vehicle being driven by individual who may be with missing child:____________________________
__________________________________________________________________________________________
Name of local law enforcement agency making request for Alert activation:_________________________________
__________________________________________________________________________________________
Name of authorizing Sheriff/Police Chief:
Signature of Sheriff/Police Chief or authorized agency commander:

______________________________________________________ Date:_________________________

FORWARD COMPLETED FORM TO:

Mississippi Highway Safety Patrol
Telephone Number: (601) 987-1530
Fax Number: (601) 987-1480
Email: troopc@dps.ms.gov

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