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 Information
Officer’s full name*
Job title*
Organization*
e.g., FBI, Sugarland Police Dept.
Requester email address*
Only official law enforcement requests will be accepted. Use official email domains only (e.g. @usdoj.gov, @greenvillecounty.org, etc).
Street address*
City*
State*
Select...
Zip code*
Phone number
Fax number
Nature of emergency*
Kinetic Target Details
Please provide Phone Number, IP Address and/or Email Address of the target.*
IP or phone number
Target email address
Time*
Time zone*
Select...
Other
Specific account information requested
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*