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C Date Prepared Hz (4) (please initial) ISRAA within 30 days from date of accomplishment) 5 Vv, 12-19-06) @ Accomplishment Report ‘Squad supervisor approval (Accomplishment must be reported and loaded into ; Date Loaded Date Loader’s Initials Investigative Assistance or Technique Used eeeate aot a File Number 4. Used, but did not help 3. Helped, substantially ; E-MM —-faFoez 2. Helped, minimally 4. Absolutely essential For Sub, Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO Rate FO laT Rate FO IAT Rate FO 1A [Fin aneiyst | MM rap ristasun | || Frecetaesc [| [Pores | oo PL eorsenit 1 ce oa SO Scere | [soc asst. BB Butte - ITC MB swattoom | MM sav-rc | Bankruptcy Fraud Computer Fraud/Abuse C) Corruption of Public Official (1 Money Laundering O Sub Invest Asst by FO(s) Rate FO IAT . juco-NatBeck| NCAVCY Vi-CAP 7 crim intl asst] | . CART FevsisNog-tocat| | RA A. B.C, De Evid. Purchase Phone Toll Rec Ft.Mon.-ITC | [NN OFCICID Inf(CW Info UGCO - Group | For. Lang Asst. | | jprp | Lab, Div, Exam UCO - Group II NonFBitabex} | fo | J. Civil Rico Matters Date: Also complete “Section G” Other Civil Matters Date: F. Conviction (Federal Di Local Conviction Date: A. Complaint / Information/ indictment (}Federat [Local [7 International Complaint Date: (2 Intemational Check if Civil Rico Complaint oO Subject Description Code *(—___)* dadgmeat_—__. Se — ; Judicial Outcome. OX Information Date: For 6F, G, H-Include Agency Code Amount $ indictment Date: 5 Palony or = al Suspension: Years Months Plea or Tria B. Locate / Arrest State: Judicial District: (Federal [local [International - Subject Priority. TA OB Oc K. Administrative Sanction Date: Subject Description Code * Type: Length: G. U.S, Code Violation __ Required for sections A, B, F and J Suspension [[] Permanent Locate Date: * (Federal Only) . Debarment or Arrest Date: Title Section # Counts Injunction Year Months (1 Subject Resisted Arrest Subject Arrested was Armed L. Asset Seizure Date: Asset Forfeiture Date: CATS # Mandatory —___L_J___ Circle below one of the three asset forfeiture: Admin, Civil Judicial, or Criminal Cc. Summons Date: (Federal (7 Local . Recovery / Restitution / PELP X []Federal [JLocal [J International Recovery Date: Code * v Amount $ Code*___sy Amount $ Restitution Date: Do not indicate $ value in Section D H, Sentence Date: Sentence Type: . M. Acquittal/ Dismissal/ Pretrial Diversion (Circle one) Date: Months Months. In Jail: Years Suspended: Years. N. Drug Seizures “ Date: (Court Ordered [1] Pretrial Diversion Probation: Years, Monins, Drug Code ° “ Code * v Amount $ Fines: $ ———— Code PELP Date: i Do not indicate $ in Section D Code* ov =Amount $ |. Disruption/Dismantlement: . Hostages(s) Released Date: Disruption Date: O. Child Victim Information Released by: (Terrorist [] Other Child located / identified Date: by 29 OY Btiving _ (Deceased Dismantlement Date: Number of Hostages: Completion of FD-515a Side 2 Mandatory P, Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks &, |, L and N ee ees es ee ee ly: VigdONs O: . 0 Subject related fo an LCN, Asian Organized Crime (AOC), Ilalian Organized Crime (1OC), Russian/Eastern European, Caribbean, or Nigerian Organizad Cnme Group - Completa FD-515a, Side 1 Blocks A-E mandatory, F-H as appropriate, oO Subject ralatad to an OC/Drug organization, a VCMO Program National Gang Strategy targe! group, or a VCMO Program National Priority Initiative targel group « Completa FD-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. eprel NG BLE S15 e See codes on reverse side. Pe v 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-NY —]06062- | 78 b6 b7c bT7E b6 b7Cc HOUSE_OVERSIGHT_021576