Diffusion dispatch form
Identity Particulars
DIFFUSION
Issuing country
With a view
To locate and trace (a criminal, a witness, etc.)
To arrest in order to serve a sentence
To arrest in order to prosecute
European Arrest Warrant issued
To search for a missing person / To identify a person suffering from amnesia
To identify an unidentified body
Recipient country(ies)
Zone(s)
All member countries (IPCQ)
Zone(s) and/or specific country(ies)
(IPCP)
Zone 2
Zone 3
Zone 4
Zone 5
Zone 6
Zone 7
Zone 8
Zone 9
and/or include country(ies)
1 - IDENTITY PARTICULARS
Diffusion Judicial information
Photographs
Fingerprints
Caution
This person may be:
Violent
Infectious
Mentally ill
Suicidal
Addicted to drugs
Armed
Dangerous
Other
1.1
Present family name
1.2
Family name at birth
1.3
Forenames
1.4
Sex
Male
Female
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1.5
Date and place of birth
Date
Place
1.6
Also known as
1.7
Other dates of birth
1.8
Father's family name and
forenames
1.9
Mother's maiden name
and forenames
1.10
Identity
1.11
Nationality
/
(dd/mm/yyyy)
(Town, country)
Confirmed
Not confirmed
Confirmed
1.12
Identity documents
/
Not confirmed
Confirmed
Not confirmed
Document 1
Type
Number
Date of issue
(dd/mm/yyyy)
Expiry date
(dd/mm/yyyy)
/
/
/
/
Place of issue
Document 2
Type
Number
Date of issue
(dd/mm/yyyy)
Expiry date
(dd/mm/yyyy)
1.13
/
/
/
/
Place of issue
Occupation
(Skills, professional qualifications,
etc.)
1.14
Languages spoken
Usual
1.15
Description
Height
Others
(cm)
Hair
Weight
(kg)
Eyes
Skin colour
Build
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1.16 Distinguishing marks and
characteristics
(Scars, tattoos, deformities,
amputations, etc.)
1.17
DNA Code
1.18 Regions/Countries likely to
be visited. Place of
residence and/or known
address
1.19
Additional information
(Date and place of previous criminal
activities, etc,)
2 - JUDICIAL INFORMATION
2.1
Facts of the case
(Events, date, place, circumstances,
modus operandi, constituent elements
of the offence, exact role played by
the offender, etc.)
Date
Place
(dd/mm/yyyy)
Identity Particulars To serve a sentence
/
/
(Town, country)
Summary
2.2
Accomplices
Family name
Forenames
Date of birth
/
/
/
/
(dd/mm/yyyy)
Comments
TO SERVE A SENTENCE
2.3
Charge(s) on which
convicted
2.4
Law covering the
offence(s)
Judicial information For prosecution
(Article, section, etc.)
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2.5
Sentence imposed
Remainder of sentence to
be served
2.6
2.7
Time-limit for enforcement
Conviction/Sentence
Conviction/Sentence
(Number, date and place of issuance,
issuing or competent judicial
authorities)
Decision handed down in offender's absence
(The person concerned has been personally summoned or
otherwise informed of the date and place of the hearing following which the judgment was handed down in his/her
absence. If the person has not been so informed, he/she will benefit from certain legal guarantees when handed over
to the judicial authorities)
Yes
No
Arrest warrant or judicial decision ordering execution of the sentence
(Give number, date and
place of issue, judicial authority, name of signatory, expiry date)
2.8
Name of signatory
Copy of conviction/sentence attached in the language used by the requesting
country
Yes
No
FOR PROSECUTION
2.3
Charge(s)
2.4
Law covering the
offence(s)
To serve a sentence European Arrest Warrant
(Article, section, etc.)
2.5
Maximum penalty possible
2.6
Time-limit for prosecution
or expiry date of arrest
warrant or judicial
decision having the same
effect
2.7
Arrest warrant or judicial
decision having the same
effect
(Number, date, place and country of
issue, issuing or competent judicial
authorities)
2.8
Name of signatory
Copy of arrest warrant attached in the language used by the requesting country
Yes
No
EUROPEAN ARREST WARRANT
For prosecution Action to be taken if traced
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The above offence(s) appear(s) on the list of the 32 offences referred to in European Council Framework Decision
2002/584/JHA of 13 June 2002 as not requiring dual criminality verification:
Yes
No
In the case of life imprisonment, is any reduction of the sentence possible (adjustment upon application by the
offender or after 20 year served, or clemency measures):
Yes
No
European Arrest Warrant:
(Number, date, place and country of issue, issuing or competent judicial authorities)
The warrant also includes provision for the seizure and handing over of property which may be required as evidence
or property acquired by the wanted person as result of the offence:
Yes
No
Description of the property (and location)(if known):
Copy of European Arrest warrant attached in the language used by the requesting country
3 - ACTION TO BE TAKEN IF TRACED
3.1
Immediately inform INTERPOL
(dd/mm/yyyy)
3.2
Yes
No
European Arrest Warrant Identity Particulars
(NCB reference:
of
/
/
) and the ICPO-INTERPOL General Secretariat that the fugitive has been found.
For countries which consider diffusion to be valid requests for provisional arrest, please provisionally arrest the
fugitive.In this connection, please state whether your country is a party to one of the following Conventions:
For countries party to the European Convention on Extradition, this diffusion is equivalent to the request for
provisional arrest referred to in Article 16.
For countries party to the Arab Convention on Mutual Assistance in Legal Matters, this diffusion is equivalent
to the request for provisional arrest referred to in Article 43.
For countries party to the Convention on Extradition concluded by the member of ECOWAS, this diffusion is
equivalent to the request for provisional arrest referred to in Article 22.
For countries party to another relevant multilateral convention under which this diffusion is equivalent to a
request for provisional arrest, give the name of the convention.
EXTRADITION WILL BE REQUESTED FROM ANY COUNTRY WITH WHICH THE REQUESTING COUNTRY
IS LINKED BY A BILATERAL EXTRADITION TREATY, AN EXTRADITION CONVENTION OR BY ANY
OTHER CONVENTION OR TREATY CONTAINING PROVISIONS ON EXTRADITION.
EXTRADITION WILL BE REQUESTED FROM ANY COUNTRY WITH WHICH THE REQUESTING COUNTRY
IS LINKED BY A BILATERAL EXTRADITION TREATY, AN EXTRADITION CONVENTION OR BY ANY
OTHER CONVENTION OR TREATY CONTAINING PROVISIONS ON EXTRADITION, WITH THE
EXCEPTION OF THE FOLLOWING COUNTRIES
EXTRADITION WILL BE REQUESTED FROM ANY COUNTRY WITH WHICH THE REQUESTING COUNTRY
IS LINKED BY A BILATERAL EXTRADITION TREATY, AN EXTRADITION CONVENTION OR BY ANY
OTHER CONVENTION OR TREATY CONTAINING PROVISIONS ON EXTRADITION, AND ALSO FROM THE
FOLLOWING COUNTRIES
European arrest warrant
This warrant has been issued by a competent judicial authority. The arrest and surrender of the above mentioned person is
requested for the purposes of conducting a criminal prosecution or executing a custodial sentence or detention order.
****
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