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B Vv. 12-19-06) quad supervisor approval (please initial) Accomplishment Report (Accomplishment must be reported and loaded into ISRAA within 30 days from date of accomplishment) Date Prepared Of Date Loaded Date Loader’s Initials Investigative Assistance or Technique Used 1. 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 Accomplishment involves: (check all that apply) File Number E-MM- | oK0e2 Drugs oO A Fugitive D oO eonleuptey Fie a Rete FO aT_—Ralo FO._—_IAT_—_—Rale FO._—TAT_—Rale FOIA Computer Fraud/Abuse O || ig Fin. Analyst | | Lab. Field Sup | | | UCO - Nat.Back | Vict-Witn Coor Corruption of Public Officiat C1 | Bim ArcrattAsst. | | [PenRegisters | JMMBNCAvcrvicaP| [NNN 10 Wanted Fiyer Money Laundering xm ita Sub Invest Asst by FO(s) nsis Neg, [I Asst. FO(s) A. B. C. Dz | | etsur/ Til | [RB showsoney | i Bi crores | | [sonst | Legats Asst. |_| | Tech. AgiEquip.| _| Evid. Purchase | | | Tvcwnie || [uco-crooi | | tsk ov. exam || [c0-crumit] | MPoc-iTc | es i fivrsitest | Crisis Neg.- Local A. Complaint / Information/ Indictment (1 Federal C1 Local + Complaint Date: (J intemational Check if Civil Rico Complaint [1] Information Date: Indictment Date: . Locate / Arrest C] Federal [Local Subject Priority: 1A (iB (Ce Locate Date: Arrest Date: (-] Subject Resisted Arrest (7) International - F, Conviction (7 Federal C1 Local Conviction Date: (2 International Subject Description Code e (__) ® For 6F, G, H-Include Agency Code (0 Fetony or (J Misdemeanor (Plea or C) Triat State: Judicial District: G. U.S, Code Violation Required for sections A, B, F and J (Federal Only) Title Section # Counts J. Civil Rico Matters Date: Aiso complete “Section G" Other Civil Matters Date: Judgment. Judicial Outcome___ OK Amount $ Suspension: Years Months K. Administrative Sanction Date: Subject Description Code Type: Length: Suspension (7] Permanent Debarment Injunction fr Year. Months L. Asset Seizure Date: Asset Forfeiture Date: CATS # Mandatory ___ Circle below one of the three asset forfeiture: Admin, Civil Judicial, or Criminal! (J Subject Arrested was Armed . Summons Date: [J Federal [J Local Do not indicate $ value in Section D » Recovery / Restitution / PELP X C Federal Citocal [7] Intemational Recovery Date: Code ® vy Amount $ Code* sy = Amount $ Restitution Date: () Court Ordered (J Pretrial Diversion Code*__ sy =Amount $ PELP Date: Code * H. Sentence Date: Sentence Type: M. Acquittal/ Dismissal/ Pretrial Diversion ' (Circle one) Date: Months_____. Months__.__ Months____ In Jail: Years Suspended: Years N. Drug Seizures “ Date: Probation: Years, Drug Code ® Weight FDIN Do nat indicate $ in Section D 0. Child Victim Information Child located / identified Date: b 29 OY Kuiving : (2 Deceased e Fines: $ Code v Amount $ |. Disruption/Dismantlement: ~“ E, Hostages(s) Released Date:. . . Disruption Date: Released by: [J Terrorist []) Other 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, I, Land N |_| Race*| sex | / datepfaitn Social Security No. (if available) Pe For Indictments/Convictionfonly: oO Subyact related to anfiCN, Asian Organized Crime (AOC), Italian Organized Crime (1OC), Russian/Enstern European, Caribbean, of Nigerian Organized Cnme Group + Compfete FD-515a, Side 1 Blacks A-E mandatory, F-H as appropriate. | Subject related to an OC/Drug organization, a VCMO Program National Gang S(rategy target group, or a VCMO Program National Priority initiative target group - Complete 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. e See codes on reverse side. Serial No, of FD-515 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. 3) E- UK 10806 2- 1F | b6 b7C b7E b6 b7c ~ HOUSE_OVERSIGHT_021602