DOJ-OGR-00028958.tif

1. Classification__= GS ‘a poy (AC) Criminal Case {CF) Asset (GA) ape r] (AO) Crminal OCDETF Case (DC) Group lt UC (GB) 0 Yj (AF) FCI Case (DD) OCDETF Group Il ie) Ai Operation (BC) Informanvcw (E} Group | (BD} InformanviCW Providing Drug into. (Fy) FC}UCO ty Per Lookout 2. Date a, 5 b3 -2' 3. Request for: } Advance ( Expense 4, Social Security No: — bé -2 b7¢ -2 ap ——e FD-794 (Rev, 2-7-00) Dratt Request b3 -3 founiieaton LC ASSEN WA G2 WANDS yc ation, . | Reset psseuln) rmant File No. Symbol No. acnd/Code Name Period Covered to One Time Nan-symbol Source Payment: - True Name: DOB: / / SSAN: Date of Waiver: i i +t. Payment for reimbursable expense - forfeiture or drug related? Yes “ No Supervisor Initials: SAC EAD) 40 / SAS Approval: u Bply Technician Approval: Draft Approval Officer: Procurement Authorization: a ae 26, Settlement of Advance: Prior = Advance -a Balance: $ ThisAdvance: 38 Less: Receipts: $ Funds Returned and! or Gash o on Hand: % Shaded areas for draft office use only Classification: v f } , Classified By: 03956-360 White Original - Submitted to Confidential Services ‘Init by Draft Office Dec'assity an: DOJ-OGR- 00028958