Appendixes B – D: Sample Forms

Appendix B: Sample Personal Items Submission Form (Adobe PDF)

After a mass fatality incident, friends and family members will provide authorities with personal items that may contain a missing person’s DNA. The DNA profile obtained from the personal item(s) will be searched against the profiles obtained from the remains samples. To efficiently and effectively use DNA analysis to identify human remains, it is important that personal items be correctly identified.

The purpose of this sample form is to help a laboratory:

  • Determine who is missing.
  • Provide information on the types of personal items that loved ones should submit.
  • Identify the submitter and the items being submitted.
  • Clarify what other DNA might be on the item; for example, if personal items of the missing individual are submitted, a reference sample from a spouse, domestic partner, or full-time roommate may be useful, even if no biological relationship exists.
  • Begin chain-of-custody documentation for the items.
  • Obtain permission from the submitter to test the items.
  • Provide notification that the articles may be damaged or destroyed during testing.

Appendix C: Sample Family and/or Donor Reference Collection Form (Adobe PDF)

After a mass fatality incident, a missing person’s friends and family members provide identification information to officials who are handling the recovery and identification efforts. Complicated family structures—for example, multiple marriages, adoptions, same-sex partners—present challenges in collecting family relationship information.

Obtaining an accurate family structure helps minimize gaps in information.

The information requested in this sample form is quite comprehensive, including a description of the jewelry worn by the missing individual, dental history, and a list of family members who may be able to provide DNA samples for the kinship identification process. This information typically is stored in the Victim Identification Program (VIP), a database supplied by the Federal Emergency Management Agency (FEMA). VIP is the central repository of all missing individual identification information, which can be accessed by pathologists, laboratory personnel, and medical examiners who are involved in the identification process.

Once family members have been identified and documented in the VIP, DNA samples need to be collected. Collection kits—used to collect the family and donor reference samples to determine biological relationships—should be available at family assistance centers and can be sent to family members all over the world.

The purpose of this sample form is to assist the laboratory in:

  • Determining the identity of the missing individual.
  • Identifying the donor of the reference sample.
  • Clarifying the biological relationship between the missing individual and the donor; for example, if personal items from the missing individual are being submitted for analysis, a reference sample from a spouse, domestic partner, or full-time roommate is useful even if no biological relationship exists.
  • Obtaining chain-of-custody information for the family reference sample.
  • Obtaining permission to test the sample.
  • Providing information on the best types of family reference samples to collect.

Appendix D: Sample Family Tree Form (Adobe PDF)

The complexity of modern family structures (e.g., multiple marriages, adoptions, same-sex partners) can challenge the collection of family relationship information. The purpose of this Sample Family Tree Form is to help a laboratory:

  • Determine who is missing.
  • Identify the individual providing the information.
  • Provide family relationship information.

This type of form should be completed each time someone provides information about a missing individual and/or donates a sample. Because of the complexity of determining biological relationships, it generally is advisable to have a trained interviewer—such as a geneticist or genetic counselor—complete the form.

Go to Next Section: Appendix E: Guidelines for Family and/or Donor Reference Collection Kit Components and Oral Swab Collection Instructions

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