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FD-515 (Rev. 12-19-06) Accomplishment Report Date Prepared Squad supervisor approval (Accomplishment must be reported and loaded into Date Loaded (please initial) ISRAA within 30 days from date of accomplishment) Date Loaders Initials Investigative Assistance or Technique Used Fite Number 4. Used, but did not help 3. Helped, substantially D 2. Helped, minimally 4, Absolutely essential nee = For Sub, Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO ugitive Banlruptey Fraud al aT Rate FO Rate FO aT Rata FO IAT (aT [Proto cover | AMcimnisinet ase] | [crisis Nea Feel | Computer Fraud/Abuse oO Corruption of Public Officiat 1 Money Laundering Sub Invest Asst by FO(s) Brno | [aicanasst || | Computer | [onsen on |O Wanted Flyer CART Vict-Witn Coor Fest FOR) ee eee] pr [esunrrse | [I sonen wera! ese ia LE EE SSC Son Soe Sco Sc mm . me Swat Team mi © PRM Leoats Asst. [FRB tech. Agieouin|| | |__| Evid. Purchase] A Phone Tot Reo| A [| Jrwewrieie | —|__[veo=croupt [fm Fo: tena cst |_| [t2b, oh Exam] | _[uco-croueit| —_flifvonrortavex| |_| J. CivilRico Matters Date: Also complete "Section G" Other Civil Matters Date: Sav - (TC [ree Fd F, Conviction (Federal []Local [7 Intemational Conviction Date: A. Complaint / information/ Indictment (Federal ([JLocal [1 Intemational Complaint Date: Check If Civil Rico Complaint C1 Subject Description Code *(__)* SLL EEE erm me Forte 28, Hepchulenk Sed Judicial Outcome___.§ ___§__ OX information Date: OP Oh, S. Heineluee Agency Vo ° Amount $ Indictment Date: = Felony or 5 MISAEMeanGr Suspension: Years Months__ Plea or Trial B. Locate / Arrest State: Judicial District: C]Federat [Local (International ' Subject Priority, OOA (1B Cc 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 Onty) Debarment or Title Section # Counts Injunction Year. Months Arrest Date: (J Subject Resisted Arrest (2 Subject Arrested was Armed L. Asset Seizure Date:. Asset Forfelture Date: CATS # Mandatory.4__ESE Circle below one of the three asset forfeiture: Admin, Civil Judicial, or Criminal C. Summons Date: (Federal [J Local . Recovery / Restitution / PELP X [Federal [JLocal [[] International Recovery Date: Code * vy Amount $ Code*__ sv = Amount $ Restitution Date: Do not indicate $ value in Section D H. Sentence Date: Sentence Type: PY M. Acquittal/ Dismissal/ Pretrial Diversion (Circle one) Date: In Jail: Years Months_____ Suspended: Years______._ Months_____ N. Drug Seizures Y Date: (1) Court Ordered {[] Pretrial Diversion Probation: Years Months_____ Drug Code * . Code * ¥ Amount $ Fines: $ ot Code PELP Date: ‘ Do nat indicate $ in Section D Code * v“ Amount $ |, Disruption/Dismantlement: E. Hostages(s) Released Date: Disruption Date: Released by: [1 Terrorist [] Other O. Child Victim Information Child located / identified Date: oof ofroy 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 a Subject related to an LCN, Asian Ofganized Crime (AOC), Italian Organized Cnme (10C), Russian/Eastern European, Carlhbean, or Nigerian Organized Crime Group - Complate FD-515a, Side 1 BlockgA-E mandatory, F-H as appropriate. Subject ralalod to an OC/Brug organization, a VCMO Program National Gang Strategy targel group, or a VCMO Program National Priority Iniliative targel group - Complate FOD-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. metal No: of FO Sle = Sau colleen eames Sha, [ 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, GWE-UK — }08062-199 HOUSE_OVERSIGHT_021618