DOJ-OGR-00030144.tif

FD-340 (Rev. 7-29-92) Universal Case File Number 2S \ e-iNM-1 0x0 G27/AN Field Office Acquiring Evidence > = EC QUA] Wy Serial # of Originating Document Date Received From (Yn ino (Name of Contriautor) {Address of Contributor) b6 -2: By b7C -2: To Be Returned (J Yes C1 No Receipt Given L Yes LJ No Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e} Federal Rules of Criminal Procedure 1] Yes ONo Title: Reference: (Communication Enclosing Material) Description: Original notes Te Interview-of- Sub BLA} oH esudsé , 03956-10077 DOJ-OGR-00030144