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wy $ FD-515 (Rev. 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) S/E= MI =[0¥ O22. 4. Used, but did not help 2. Helped, minimally Drugs A Fugitive O Bankruptcy Fraud Oo Computer Fraud/Abuse O Corruption of Public Official 1 Money Laundering Sub Invest Asst by FO(s) Asst. FO(s) AB. OC. OD. Rate FO IAT Rate FO IAT [Ficacavei |_| [areatass | |_| f [onsen on | = [ewsuarrn |_| Evid. Purchase Inf/CW Info F. Conviction CO Federal EI Loca! Conviction Date:. A. Complaint / Information/ Indictment (Federal (Local Complaint Date: Check if Civil Rico Complaint 0 (J International (7 international Subject Description Code _—= . For 6F, G, H-Include Agency Code (1) Felony or (Plea ‘or State: Information Date: (1 Misdemeanor (J Triat Judicial District: Indictment Date: B, Locate / Arrest (Federal [CJLocal [[] International : Subject Priortyy A OB Oc Locate Date: G, U.S, Code Violation Required for sections A, B, F and J (Federal Only) Title Section # Counts Arrest Date: (2 Subject Resisted Arrest (CD Subject Arrested was Armed Cc. Summons Date: (Federal [[] Loca! D, Recovery / Restitution / PELP X [} Federal [JLocal [7] International Recovery Date: Code ®_. vy = Amount $ Code * ¥ Amount $ H. Sentence Date: Sentence Type: t Months__ Months____ Months_____ In Jail: Years, Suspended: Years. Restitution Date: [} Court Ordered ([) Pretrial Diversion Code*_ v= =Amount $ PELP Date: Code * ‘ Probation: Years Fines: $ ¥ Amount § 1, Disruption/Dismantlement: Vv E. Hostages(s) Released Date:, . . Disruption Date: Released by: [] Terrorist [1] Other Dismantlement Date: Number of Hostages: __. Completion of FD-515a Side 2 Mandatory P, Subject Information - Requireg for all blocks excluding block D (Recovery/PELP), blocks E, I, Land N —— > | Race? | Datg of Birth O Subject related to an Completa FD-5152, Side 1 Blocks A-E mandatory, F-H as appropriate, Investigative Assistance or Technique Used For Sub. Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO fan revse | _| enresites |_| | rrcis cover | fevsunvrise | | | seoen Weran) | Tsocass. |_| B svaiteon |_| ech. area] | [rhone Ta Rec | [| vc0-crupi | | Fiat ov. am | [eo crevor] hf Asian Organized Crime (AQC), Italian Organized Come (IOC), Russtan/Ensiern European, Caribbean, of Nigenan Organized Crime Group - Date Prepared 27 & Date Loaded ag b6 Date Loader’s Initials b7C b7E 3. Helped, substantially 4, Absolutely essential Rate FO \AT Rate FO IAT | | UCO - Nat.Back: || ae Vict-Witn Coor Me NCAVC! VI-CAP ip (0 Wantad Flyer imsnis ttt asst] | Jorisis Neg Fed| | risis Neg Local |_| ERT Asst. a Butte - ITC Sav - ITC |_| Broce || fen Fatteb ee] |_| J. Civil Rico Matters Date: Also complete “Section G” Other Civil Matters Date: Judgment Judicial Outcome___.___ OX Amount $ Suspension: Years CART ert separa Months__ K. Administrative Sanction Date: Subject Description Code Type: Length: A Suspension {J Permanent Debarment or Months Injunction Year. L. Asset Seizure Date: Asset Forfelture Date: CATS # Mandatory —__ Circle below one of the three asset forfeiture: Admin, Civil Judicial, or Criminal Do not indicate $ value in Section D M. Acquittal/ Dismissal/ Pretrial Diversion {Circle one) Date: N. Drug Selzures “ Date: Drug Code ® Weight FDIN Do nat indicate $ in Section D O. Child Victim Information Child located /identified Date: _O of oprey PRriving (1 Deceased Code” b6 b7c Social Security No. (if available) Subject related to an OC/Drug organization, a VCMO Program National Gang Stralegy target group, ora VCMO Program Naliona! Priorily Inilialive largel 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. WE - MU-~ (08062-203 HOUSE_OVERSIGHT_021626