DOJ-OGR-00029278.tif

“U.S. GPO: 2002-487-337/51259 Record Request FO-125 (Rev. 46-1-93) * * ° ® e a = @ e | | Date 53 /o} /2006 cj Birth Credit Xf crimina Pl Geath fi INS f ] Marriage* Ge Vehicle f_] other A File number SA Sle- MM ~ 168062 4/92. Name and aliases Qr—supyect;—appricant;—cr-eMmloyec, and spouse _ a : - be - 3, 2 Addresses Residence Business Buded Return to Former “Date and place off marriage (if applicable) Race Age Height ‘ Weight Hair Eyes Sob Birth date __ Birthplace — : — on Arrest Number ps Fingerprint classification Criminal specialty Social Security N Brivers License Number Specific information desired Res ov ~] a ta = oom ee re ea Te 03956-5794 DOJ-OGR- 00029278