Exigent Request Form | Kinetic by Windstream

Exigent Disclosure Request Form

If there is an emergency involving the danger of death or serious physical injury to a person that Windstream Services, LLC may have information necessary to prevent, you may submit an exigent disclosure request below.

LEA Contact Info

Officer's Full Name *

Job Title *

Organization *

e.g., FBI, Sugarland Police Dept.

Requester Email Address *

Official email domain only (e.g. usdoj.gov, met.police.uk, @greenvillecounty.org)

Address *

City *

State *

Zip Code *

Phone Number

Fax Number

Nature Of Emergency

Suicide / Self-harm

Threat to another person

Threat to a place

Other threat

Windstream Details

IP or Phone Number

Date

Use the following format: YYYY/MM/DD H:MM TT

Target Email Address

Select Time Zone

Other

Specific Account Information Requested

Basic account information

Recent Call logs

Other account information

Why is this information necessary?

Please provide any additional details

PLEASE NOTE: Requests submitted through this form are reviewed and responded to as quickly as possible. Questions about submissions will be directed to the email address provided above

Signature: Please electronically sign this notice by typing your full name

Full Name *

* Denotes Required