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B Vv, 12-19-06) © Accomplishment Report ® Date Prepared 29/0 S quad 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 41. 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 IAT Rate FO Rate FO 1a Rate FO IAT IAT T BG nanos [Bec rowsu [| [uco-natsaci| | [computer [| | Photo Cover | BB criovns totet Asst] | | [eensenmon_| I cic Nop Feel _| fesur/risc| | [search warant| Ii feusun rt |AIM stow money [Meer asst | fF Suppor Pal | |socass. | | [swat Team [PMB Savi Accomplishment involves: (check all that apply) Fille Number O Computer Fraud/Abuse Corruption of Public Official Money Laundering Sub Invest Asst by FO(s) i [| ve Pues | ll Pion To os | fiat onan | | _|vco-crunit] — fvonraicees| | |__| J, Civil Rico Matters Date: Also complete “Section G" Other Civil Matters Date: F. Conviction ()Federal [Local [1] Intemational Conviction Date: A. Complaint / Information/ indictment ()Federat [Local [7 Intemational Complaint Date: Check if Civil Rico Complaint Subject Description Code *(__)* SEG SE ey a . For 6k G, H-nclucie A nd Judicial Outcome__ Ss _X i . or 6F, G, H- le le Information Date: neiude Agency Co Amount $ Indictment Date: = iad or 5 ta Suspension: Years -— Months Plea or Tria B, Locate / Arrest State: Judicial District: (Federat [JLocal [[ International Subject Priority: OA 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) A Debarment or Arrest Date: Title Section # Counts Injunction Year Months (2 Subject Resisted Arrest (JJ Subject Arrested was Armed L. Asset Seizure Date: Asset Forfeiture Date: CATS # Mandatory __E Circle below one of the three asset forfeiture: Admin, Civil Judicial, or Criminal Do not indicate $ value in Section D C. Summons Date: (Federal [J Local D. Recovery / Restitution / PELP X [Federal [JLocal [7 International Recovery Date: Code * v Amount $ Code* sy Amount $ Restitution Date: H. Sentence Date; Sentence Type: . M. Acquittal/ Dismissal/ Pretrial Diversion (Circle one) Date: Months____ Months______ In Jail: Years. Suspended: Years. N. Drug Seizures “ ‘Date: (J Court Ordered [[] Pretrial Diversion Probation: Years Months__. Drug Code ® ; Code ° Y Amount $ Fines: $ Weight —______. Code PELP Date: FDIN ater z Do not indicate $ in Section D Code * v Amount $ | Disruption/Dismantlement: “ E, Hostages(s) Released Date:, ; Disruption Date: Released by: (J Terrorist [ Other 0. Child Victim Information Child located / identified Date: O&S/Z0 oy Dismantlement Date: PRriving (7 Deceased Number of Hostages: Completion of FD-515a Side 2 Mandatory P, Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks E, Il, Land N tice] sex [fon gta Seri (rvaany | Tor y.”~ti“‘i‘ish UU [_J Subject retatedto an Asian Organized Crime (A . Kattan Organized Cnme (IOC), Russian/Eastern European, Caribbean, or Nigerian Organized Crme 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 Nalional Gang Slrategy targot group, or a VCMO Program National Priority Inilialive 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. Serial No. of FD-515 e See codes on reverse side, | ¥ 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. AENMY - (0062-19 b6e b7C¢ HOUSE_OVERSIGHT_021614