DOJ-OGR-00029279.tif

"" Recond Request FD-]25 (Rev. 4-1-93) Date b O oe O o7 O Birth O Credit AY Criminal Death O INS) OO Marriage* (© Motor Vehicle “O Other b6 - 2 BTC - 2: File Number 2\EWN-.1OSOG 2. Retum to Sft Name and aliases ofsubject, applicant, or employee, and spouse Business Former - , * Date and place ofmariage — b6 - 3 -(ifapplicable) : b7C - 3 Eyes Race se Age Height 4 Female iJ O Male Birth date Birthplace Agrest Number Fingerprint classification Criminal specialty Social Security Number Divers License Number | O D/L Photo O Other Specific information desired N CEO Results of check b7E - 7 03956-5805 DOJ-OGR- 00029279