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FD-515 (Rev. 12-19-06) & Accomplishment Report Squad supervisor approval (Accomplishment must be reported and loaded into (please initial) ISRAA within 30 days from date of accomplishment) 1. Used, but did not help 2. Helped, minimally File Number |S e-Mm-/O¥ 067} Drugs | A Fugitive oO Bankruptcy Fraud. Computer Fraud/Abuse Corruption of Public Official Money Laundering Sub Invest Asst by FO(s) Asst. FO(s) A. B.C. Dz Rate FO 1A Lab. Field Sup Oo Fin, Analyst Aircraft Asst. Pen Registers Photo Cover ELSUR /FISG Ww As it Te t ral Eng, Tepe Ex Legats Asst T Polygraph Show Money SOG Asst. Swat Team Tech gl=quip Phone Toll Req UCO - Group | UCO - Group Ill ELSUR /T. fll Eng. Field Spt 1A . P ne Inf/CW Info ‘T Lab. Div. Exa investigative Assistance or Technique Used For Sub. Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO = g 9 3 Qo ie ba] nen we a qj z c iz) iS B m o Xx a. Date Prepared x Date Loaded r Date Loader’s Initials b6 b7C b7E 3. Helped, substantially 4. Absolutely essential AT Rate FO UCO - Nat Back NCAVCI VI-CAP CrimNS Intel Ass Grisis Neg.~ Local ERT Asst, Butte - ITC Sav -1TC Ft, Mon, - ITC For, Lang Asst. [ppp P| A. Complaint / Information/ Indictment J. Civil Rico Matters Date: (Federal []Local (] International : ; Alse complete’ "Section" Complaint Date: Check if Civil Rico Complaint O Other Civil Matters Date: Judgment Judicial Outcome = OK Information Date: Amount $ Indictment Date: ‘ Suspension: Years Months 0 Tria or . LocatefArrest.. Stal ae ol Oo Judicial District: K. Administrative Sanction Date: Ci Federal JxLLoca (2 international Subject Description Code —____ G. U.S. Code Violation Type: Locate Date: (Federal Only) Length: Debarment or Subject Priority: CJA (1B c __ Required for sections A, B, F and J . : Suspension ([] Permanent Arrest Date: OG fa) Title Section # Counts Injunction Year, Months (1) Subject Resisted Arrest nil a a L. Asset Seizure Date: (FJ Subject Arrested was Armed Asset Forfeiture Date: ee oo CATS # Mandatory . Summons Date: Circle below one of the three asset forfeiture: (Federat [7] Local Admin, Civil Judicial, or Criminal Do not indicate $ value in Section D . Recovery / Restitution / PELP X C1] Federal [JLécal [1] International H. Sentence Date: Recovery Date: Sentence Type: \ Code * vy Amount $__ Code*___sv Amount $ In Jail: Years___ Months, M. Acquittal/ Dismissal/ Pretrial Diversion (Circle one) Date: Suspended: Years.____ Months______ N. Drug Seizures “ Date: Restitution Date: (1) Court Ordered {J Pretrial Diversion Probation: — Years_____. Months_____. Drug Code * Weight Code * YA Fines: $ mount $. EDIN PELP Dates. 7 Code * ¥ Amount $s 1, Disruption/Dismantlement: “ Code * Do not indicate $ in Section D E. Hostages(s) Released Date: 0. Child Victim Information Disruption Date: Released by: [] Terrorist (] Other Child located / identified Date: Dismantlement Date: Number of Hostages: = : Completion of FD-515a Side 2 Mandatory CL] Living P. Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks E, I, Land N (CJ Deceased [tong —*dCRaet|sex | Datoottith__——‘|_—_—Sodel Soyo Wai) | J2Wrey Epstem [Ol lol /zo/iass [ato-W~334e For tndictments/| (6) viclions only: Subject relaled to an LCN, Asia Organized Crime (ACC), Italtan Organized Cnme (IOC), Russian/Eastern European, Caribbean, or Nigerian Organized Crime Group + Complete FD-515a, Side 1 Blocks A-E mandatory, F-H as appropriate. . 0 Subject related to an OC/Drug organization, a VCMO Program National Gang Strategy targa! group, or a VCMO Program National Priority (nitialive largel group - Complate FO-515a, Side 1 Blocks A-C only, x Additional information may be added by attaching another form or a plain sheet of paper for additional entries. e See codes on reverse side. Serial No. of FD-515 ” Requires that an explanation be attached and loaded into ISRAA for recovery over $1 m and PELP over $5 m, disruption, dismantlement, and drug seizures. ale- Hh ~ /08062-/'76 HOUSE_OVERSIGHT_021571