Name of the missing person
Date of birth of the missing person (if known)
Has the person been reported missing to police?
NoYesUnknown
If yes, in which state have they been reported as missing?
ACTNSWQLDNTVICWATASSAOverseasUnknown
Which State or Territory the person is missing from?
Please provide your information regarding the disappearance of this missing person. If possible please include the date, times, and any location details of the information.
Where did you recognise or become aware of the missing person?
Foxtel (through Missing Persons Fact Files)National Missing Persons PosterFoxtel CI NewsletterInternational Centre for Missing and Exploited Children WebsiteWIN Television - Without A Trace profilesRadio SegmentsWIN Television - Missing Persons Unit profilesFamily or FriendWoman's Day website profilesNMPCC websiteMySpace website profilesOther
Have you lodged this report with any other police agency?
NoYes
If yes, who did you lodge your report with?
Please note: It is not mandatory to fill in the below details if you wish to remain anonymous.
Title Please Select Mr Mrs Ms Miss Dr
Given name/s
Surname
Preferred name
Contact phone (include overseas country codes, if applicable)
Contact fax (include overseas country codes, if applicable)
Street address/PO Box
Suburb
State
Postcode
Country
Email address
Please indicate if you give permission for the NMPCC to provide your contact details, if required, to relevant agencies.
