DOJ-OGR-00029692.tif

e (— FP-340 (Rev. 4-11-03) . File Number S\ Ee - WM- leo 5 Olo 2. 7/4 123 Field Office Acquiring Evidence 2 C. £: Serial # of Originating Document Date Received From | (Name of Contributor/interviewee) i = | (Address) ~ = (City and State) b6 -2 By a b7C -2 To Be Retumed {1} Yes - EF No Receipt Given [1 Yes [1-No Grand Jury Maierial - Disseminate Only Pursuant to Rule 6 (e) Federal Rules of Criminal Procedure {1 Yes Dexa Federat Taxpayer Information (FTI) [Ll Yes Pie Title: Reference: (Comninnication Enclosing Material) “e" Description: Ol Original notes re interview of sol Oe aohrce lV \e tn bé -3 MH b7Cc -3 03956-8444 DOJ-OGR- 00029692