DOJ-OGR-00029856.tif

FD-340 (Rev. 4-11-03} Fite Number ___ OLE -(nyy\- lO OG2. m Field Office Acquiring Evidence AMI PREC A i Serial # of Originating Document Date Received OnNK OLA SN _ i From (Name of Contributor/Interviewee} A (Address) * - ij City and Siate By To Be Returned [J Yes - Receipt Given [1 Yes Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) ‘Federal Rules of Criminal Procedure na [i Yes Leng Federal Taxpayer Information (FTD) Ll Yes CHNo Title: Reference: (Communication Enclosing Material) t Description: Lj Original notes re interview of DOJ-OGR- 00029856