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@ Date Prepared Vv. 12-19-06) Accomplishment Report ‘Squad supervisor approval (Accomplishment.must be reported and loaded into ; Date Loaded (please initial) ISRAA within 30 days from date of accomplishment) Date Loader’s Initials investigative Assistance or Technique Used 4. Used, but did not help 3. Helped, substantially 2. Helped, minimally 4, Absolutely essential For Sub, Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO File Number Rate FO IAT Rate FO 1A Rate FO aT aT T [Finvanaist | BMMfst rctssim | | [uco-nesoer] | [Atrcrattasst. | | [PenRegisters | [MMM ncavcrvicap| [MM [0 Wanted Fiyer| | [Photo Cover | | O O Bankruptcy Fraud { Computer Fraud/Abuse O Corruption of Public Official 1 Money Laundering Sub Invest Asst by FO(s) | [essurvrisc}] | [soarchWwarent| MM GisisNep-Local| | || esur/T.t_| [show Money | [MMerTass. | Jeng. ried Set| | [socass. |_| Eng. Tope Ex. | [MM SwatToam |__| | BR Tech. agiecuin.| | | FRB Phone Tot Rec | Ft. Mon. -170 | Frcwine | | [uco-ceunt | [tsb cern) | _[uco-coue| —flgironreiuabex] | F. Conviction J. Civil Rico Matters Date: Also complete “Section G” Other Civit Matters Date: (Federal [Local [1 Intemational Conviction Date:_ A. Complaint / information/ Indictment CiFederat ([Jtocal [1] Intemational Complaint Date; : ooge e Check if Civil Rico Complaint [1 Subject Description Code *(__)* hetnuan —_—— : udicial Outcome OX Information Date: For 6F, G, H-Include Agency Code Amount $ Indictment Date: ‘ 5 ae or 5 ‘a Suspension: Years Months___., Plea or rial State: Judicial District: K. Administrative Sanction Date:, Subject Description Code = Type: Length: B. Locate / Arrest (Federal [JLocal [(] International: Subject Priority. OA OB [Ic G, U.S, Code Violation Required for sections A, B, F and J Suspension [1] Permanent Locate Date: (Federal Only) H Debarment or Injunction Year. Months Arrest Date: Title Section # Counts (-] Subject Resisted Arrest (DF Subject Arrested was Armed L. Asset Seizure Date: Asset Forfeiture Date: CATS # Mandatory Circle below one of the three asset forfeiture: Admin, Civil Judicial, or Criminal C. Summons Date: (Federal [[] Local D, Recovery / Restitution / PELP X ()Federat [Local [1] International Recovery Date: Code * vy Amount $ Code*. ev =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 VY Date: {] Court Ordered {[ Pretrial Diversion Probation: Years Months___ Drug Code * = | Code*__ ev = Amount $ Fines: $ i ael PELP Date: ° Do not indicate $ in Section D Code * v¥ Amount $ |. Disruption/Dismantlement: Vv E. Hostages(s) Released Date: : Disruption Date: Released by: [1] Terrorist [] Other 0. Child Victim Information , Child located / identified one 06 of aay Phriving _ [) 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 E, |, Land N 1 ae eee Social Security No. (if available) Fo Sree Te n o e pray cryanized Crime (1OC), Russlan/Eastern European, Caribbean, or Nigerian Organizad Crime Group - Complete FD-5158, Sida 1 Blocks A-E mandatory, F-H as appropriate. Subject related to an OC/Drug organization, s VCMO Program National Gang Stralegy target group, or a VCMO Program National Priority Inillalive target 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. Belial IO; Gf POG TG e See codes on reverse side, | t—“‘“CSCS*‘*C 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, JF EU (0806 2-98 HOUSE_OVERSIGHT_021606 |