DOJ-OGR-00028955.tif

FD-794 (Rev. 2-7-00) ~1. Classification {Ac} cnmnat {CF) Asset os S0G {AD} Criminal OCDETF Case (BC) Group i] UCO OPS {AF} FCI Case {OD} OCDETF Group It (60 Air Operation (8C)} infermanucw {E} Group i S56 1 (BD) informantiCW Providing Drug info {F) Foluce iy FCI Lockout Draft Request 4. Request tor: Advance Expense | a 16. Justilication: mit vee —e Assev/informant Fite No. Symbol No. Paymeni/Code Name E Period Covered to One Time Non-symbol Source Payment: * True Name: DOB: / } SSAN: Date of Waiver. / i 11, Payynent for reimbursable expense - fortelture or drug related? “Yes Supervisor !nitials: SACTESACY AO / SAS Approval: Supply Technician Approval: Dratt Approval Officer: L a es Ac emer De ar BES CT Fe i prewe beme mappa 28. Settiement of Advande: prigr month Advance Balance: $ This Advance: = $ Lesa: Receipts: $ Funds Retureed and/or Cash. on Hand: $ 28. Draft Ne: Shaded areas for draft office use only Classification: és Classified By: __ 93926 351 White Original - Submutted to Confidential Sarvinae Tints be MR pee oo DOJ-OGR-00028955