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f ‘ D. p -515 (Rev, 12-19-06) “Squad supervisor approval (please initial) Accomplishment Report (Accomplishment must be reported and loaded into ISRAA within 30 days from date of accomplishment) Accomplishment involves: (check all that apply) 4. Used, but did not help 2. Helped, minimally File Number [S/E-MIN-16¥ Oz! doan Pa ac aNie Drugs QO A Fugitive O Bankruptcy Fraud im Computer Fraud/Abuse Oo Corruption of Public Official 0 Money Laundering Sub Invest Asst by FO(s) Asst. FO(s) A B.C. OD. [Aiccrantasss [| | ELSUR/T.N | | Rate FO IAT Rate FO Fin,Analyst | | Consen Mon. Eng. Tape Ex. Legats Asst. || Evid. Purchase |__| introw info A, Complaint / Information/ Indictment (Federal []Local Complaint Date: F, Conviction Federal C1 Locat Conviction Date:. (J Intemational ( Intemational Check if Civil Rico Complaint 1 Subject Description Code e (——)* Information Date: For 6F, G, H-Include Agency Code (1 Felony or (Plea or State: (C Misdemeanor 0 Trial Judicial District: indictment Date: B, Locate / Arrest (Federal ([J]Local {J International : Subject Priority. OA OB Oc Locate Date: G. U.S. Code Violation Required for sections A, B, F and J (Federal Only) Title Section Arrest Date: () Subject Resisted Arrest ( Subject Arrested was Armed C. Summons Date: (Federal [7] Local D, Recovery / Restitution / PELP X [Federal [JLocal [7 International H, Sentence Date: Recovery Date: Sentence Type: ' ' *, e Code % Amount § In Jail: Years Months___ Cede * Y Amount $ Months____. Months_____ Suspended: Years. Restitution Date: _. [] Court Ordered = [[] Pretrial Diversion Probation: Years, Code* v= Amount $ Fines: $ PELP Date: 7 Code * ¥ Amount $ I. Disruption/Dismantlement: “ E. Hostages(s) Released Date: Disruption Date: Released by: (J Terrorist [7] 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, f, Land N Oo Subject related to. an LCN, Asia Org Complete FD-515a, Side 1 Blocks A-E mandatory, F-H as appropriate, 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. e See codes on reverse side. [ren Registers | | [eompuier | | |Proiocover |_| [Consen Mon, | [MM Poyorann || PeusuriFisc| | search Warant| | FELSUR/T. IN | Show Money [Eno.Feldsen| | [socass. |_| [swat Teom |_| MTech. Agizcuip.| | ieee [tab oh Exam] | _[uc0-Grow il] —_| ee re jagzed Crime (AOC), Italian Organized Crma (10C), Russian/Eastern European, Caribbean, or Nigerian Organized Crime Group - Investigative Assistance or Technique Used 3. Helped, substantially 4. Absolutely essential For Sub, Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO IAT Lab. Field Sup d. Civil Rico Matters Amount $ Suspension: Years K. Administrative Sanction Date: Subject Description Type: Length: Suspension _[[] Permanent Debarment or Injunction Year Months L. Asset Seizure Date: Asset Forfeiture D 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 Seizures “ Drug Code ® Weight FDIN Do not indicate $ in 0. Child Victim Information Child located /identified Date: ovfgofrroy Priving oO Subject relaled to an OC/Drug organization, a VCMO Program National Gang Sirategy target group, or a VCMO Program National Priority tnitialive target group - Rate FO \AT | | Juco-Natacr| | Be crisis ies | ERT Asst. | Sav- ITC Also complete “Section G" Other Civit Matters Date: Judgment... Judicial Outcome. ox Date Prepared 29 Date Loaded Date Loader's Initials Rate FO IAT | Vict Witn Coor | Coor 10 Wanted Flyer [eee a Date: Months__ Code * ate: Date: Code ° Section D (J Deceased Social Security No, (if available) 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. B/E-MM- 108062 - 20% b6 b7C HOUSE_OVERSIGHT_021636 |