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ev. 12-19-06) © Accomplishment Report ® Date Prepared ee Y 4 Squad supervisor approval (Accomplishment must be reported and loaded into . Date Loaded OF (please initial) ISRAA within 30 days from date of accomplishment) Date Loader’s Initials | b7c : b7E Investigative Assistance or Technique Used File Number 4. Used, but did not help 3. Helped, substantially o E-MMN-[oKvocz 2. Helped, minimally 4, Absolutely essential ia For Sub. invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO Bankruptcy Fraud oO ry Rate FO 1aT Rate FO IAT Rate FO IAT Rate FO IAT Computer FraudiAbuse Ee ee Ce Corruption of Public Official [1] | Aiecettass. [| [PenRecisters | [i cavcrvicar| Sub Invest Asst by FO(s) ‘ Asst. FO(s) || [etsurvrisc]| | | search Warrant|___ [MMMMNECrisis Nog Local| [NNN Asset Forf Prog] AB. CG, D. | | [evsurst.n | show Money BB eRTAsct. | _ [RM Fort Support Pro] Bro ricaso| | |socast | . ae on [Legats asst, | FRM Tech. AgrEquip.| FMM Poo- rc | Infraardioyd | | Evid. Purchase Phone Toll Rec| _fMBFL.Mon.-1T¢ | [IN OFCICIO Tincwiee [| [uco-cruns | [MBFoctanodsst | frre A. Complaint / Information/ Indictment F. Conviction J. Civil Rico Matters Date: [Federal [C)Locat [1 Intemational [Federal ([]Local [1 Intemationat Also complete “Section G” Complaint Date:_ Conviction Dates Other Civil Matters Date: . sgt e Check if Civil Rico Complaint Subject Description Code *(__)» RL ETT . For 6F, G, Heinclide A Cod Judicial Outcome___ OX i : or 6F, G, H-include Agency Code . Information Date: gency Amount $ Indictment Date: L Felony or CL Misdemeanor Suspension: Years Months [Plea or 0 Trial : B, Locate / Arrest State:________ Judicial District: ____. K. Administrative Sanction Date: [J Federal [Local [International ‘ Subject Description Code ; . G. U.S, Code Violation Type: Length: Subject Priority: OA OB Oc Required for sections A, B, F and J : Suspension _[[] Permanent LocateDate: (Federal Only) H Debarment or Arrest Date: Title Section # Counts Injunction Year. Months (CF) Subject Resisted Arrest err nel _ L. Asset Seizure Date: LL Subject Arrested was Armed Asset Forfeiture Date: ee ons TT CATS # Mandatory __E Cc. Summons Date: Circle below one of the three asset forfeiture: (0 Federat [1 Local Admin, Civil Judicial, or Criminal Do not indicat lue in Section D D, Recovery / Restitution / PELP X Hl Sentence Dat o Rat indicate Salven Seetian ClFederat []Local [] Intemational eMEMENCE Dates Recovery Date: Sentence Type: M. Acquittal/ Dismissal/ Pretrial Diversion ° Circle one) Date: tome af ATUGONE & In Jail: Years.____.___... Months. ( . Code*__s vy =Amount $ Suspended: Years___ Months _— N. Drug Seizures “ Date: Restitution Date:__ (1) Court Ordered (Pretrial Diversion Probation: = Years______ Months__ Drug Code * . Code * ¥ Amount $ ' Fines: 5s iia Code PELP Date: : Do not indicate $ in Section D Cede * ¥ Amount $——______. |. Disruption/Dismantlement: ~“ E, Hostages(s) Released Date:____ . O. Child Victim Information Disruption Date: a b Released by: [1 Terrorist [1] Other Child located / identified Date: oX¥ Dismantlement Date:___ , Number of Hostages:__E bu fi D. d . Completion of FD-515a Side 2 Mandatory Ming , ()Deceese ry P. Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks E, f, Land N | | || Race* | Sex | Date of Birth Social Security No. (if available) b6 b7C Leth { related to an LCN, Asian Organized Cama (AOC), Italian Organized Cnme ({0C), Russian/Eastern European, Caribbean, or Nigerian Organized Crime Group - Complete FD-518a, Side 1 Blocks A-E mandatory, F-H as appropriate, Subject relatad to an OC/Drug organization, a VCMO Program National Gang Slralegy targel group, or a VCMO Program National Priority Initiative targel group « Complete 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. padel Nordine ete « See codes on reverse side. Y 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. BYE- WU-106062-) 74 HOUSE_OVERSIGHT_021578