DOJ-OGR-00030045.tif

FD-340 (Rev. 4-11-03) File Number r M “O) Pt i} Field Office Acquiring Evidence Serial # of Originating Decument __~ Date Received Lo From Me] Peace | t 1 i {Name of Contributor/Interviewee} (Address) ~ ™~ (City and State} By To Be Retuned CI Ves - Receipt Given [2 Yes Lt Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) Federal Rules of Criminal Procedure [I Yes iio Federal Taxpayer Information (FTD [i Yes Eee Title: Reference: (Comminnication Enclosing Material) ae Description: g Original notes re interview of a A 03956-92 49 DOJ-OGR-00030045