DOJ-OGR-00029638.tif

(~ C File Number _ ole. UM: los. “lf (a Field Office Acquiring Evidence He | Pece a Serial # of Originating Document _~ Date Received —_Yeomoa's goo From {Name of Contributor/Interviewee} i FD-340 (Rev, 4-11-03} | { {Address} ~ (City and State} Sees To BeRetumed CI Yes - _ EYNo Receipt Given [Yes Li-NG - Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e} Federal Rules of Criminal Procedure EY Yes {1 Ne— Federal Taxpayer Information (FTD fi Yes Co Title: Reference: * {Communication Enclosing Material} “yt , tT Description: [] Original notes re interview of 1. “* 03956-837 ad DOJ-OGR- 00029638