DOJ-OGR-00029809.tif

FD-340 (Rev. 4-11-03) File Number ___s - - {OS 0 —/F 132 : Field Office Acquiring Evidence Mu} Paces | | | Serial # of Originating Document __— Date Received iA CAOQO Se From ~ (Name ofContributovinterviewee) oo ne nee . {Address} ~ é ~ : ie By fm To Be Returned £1] Yes - [Ne Receipt Given [1 Yes [no Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e)} Federal Rules of Criminal Procedure . [i Yes [i No Federal Taxpayer Information (FTI) C1 Yes No Title: Reference: - (Communication Enclosing Material) Yo Description: f.] Original notes re interview of Bieace ontal tate oo —— ial As =. st tye ae ! a 1 t i 03956-8731; DOJ-OGR- 00029809