PILPG Chain of Custody Summary Sheet GENERAL ARTICLES INFORMATION NAME OR ID NUMBER OF COLLECTOR: Please provide the name or identification number of the individual filling in this form. Use of full name may put that individual at risk. If so, use an identification number or code instead. NAME ORGANIZATION COLLECTOR: Please provide name of organization to which the individual filling in this form is affiliated, if any. ITEM REFERENCE NUMBER (if applicable) LOCATION OF ORGANIZATION: Please provide location of organization to which the individual filling in this form is affiliated, if any. NAME OR ID NUMBER OF PERSON FROM WHOM RECEIVED: If not the original collector of the document, provide the name or identification number of the person from whom the document was obtained. ITEM REFERENCE NUMBER (if applicable) NAME ORGANIZATION OF PERSON FROM WHOM RECEIVED: Please provide name of organization to which the person from whom the document was obtained is affiliated, if any. This is important in case follow-up regarding the original collection is needed. ITEM REFERENCE NUMBER (if applicable) LOCATION: Please provide location of organization to which the person from whom the document was obtained is affiliated, if any. LOCATION FROM WHERE OBTAINED: REASON OBTAINED: Please provide location from where the document was obtained in as much detail as possible. Address, location in room, cabinet, file. In as much detail as possible, please provide the reason(s) why the document was obtained by the individual filling out this form. Safe keeping, request for support, on request etc. This is important in order to establish the context of the document at a later stage. ITEM REFERENCE NUMBER (if applicable) ITEM REFERENCE NUMBER (if applicable) DATE/TIME OBTAINED: Please provide date and time of obtaining the document as accurately as possible, to the minute if possible. Timelines can be important when relied upon in court. ITEM REFERENCE NUMBER (if applicable) 64

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