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E , 12-19-06) 6 Accomplishment Report @ Date Prepared ZY Q 4 b6 quad supervisor approval (Accomplishment must be reported and loaded into Date Loaded os please initial) ISRAA within 30 days from date of accomplishment) Date Loader’s Initials b7¢c 4. Used, but did not help 2. Helped, minimally File Number Drugs oO A Fugitive Oo Bankruptcy Fraud O Computer Fraud/Abuse O Corruption of Public Official 1 Money Laundering Sub Invest Asst by FO(s) ELSUR /FISC AB. oC, OD. ELSUR/T. Ill Evid. Purchase Inf/CW Info Rate FO 1AT Rate FO Fin, Analyst || F, Conviction Cl Federal [Local Conviction Date: A. Complaint / information/ Indictment (]Federal [Local Complaint Date: (1 International (7 Intemational Check if Civil Rico Complaint. Subject Description Code *(—)" For 6F, G, H-Include Agency Code (Felony or (1 Plea or State: information Date: (7 Misdemeanor ( Triat Judicial District: indictment Date: B, Locate / Arrest (Federal ([JLoca!l [Z International - Oc G, U.S. Code Violation Subject Priority: OA (1B Required for sections A, B, F and J Locate Date: (Federal Only) Arrest Date: . Title (2 Subject Resisted Arrest (7) Subject Arrested was Armed Section # Counts Cc. Summons Date: (Federal [] Locat D, Recovery / Restitution / PELP X (Federal [JLocal [[] International Recovery Date: Code * vy Amount $ Code ° Y Amount $ Restitution Date: —— (1) Court Ordered {([} Pretrial Diversion Code*___s v ~=Amount $ PELP Date: Code * H. Sentence Date: Sentence Type: Years______... Months Months Months____ In Jail: Suspended: Years. Probation: Years, Fines: $ ¥ Amount $ 1. Disruption/Dismantiement: “ E. Hostages(s) Released Date: . . . Disruption Date: Released by: (Terrorist (Fj 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, |, L and N eer Investigative Assistance or Technique Used For Sub. Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO iat [Aircratt asst, | | [PonRegisters | | ee |_| Search Warrant | s0GAsst | | | Lab. Div. Exam] — | [uco-Group i b7E 3. Helped, substantially . 4. Absolutely essential Rate FO _1AT_~—sRato FO) IAT | | Juco-nateack] I vict-witn coor lee | Pl ME NCAVC! Vi-CAP cris tne asst] JorisisNeg. Fed] | isis Nop.-Local| | MBERTAsst. |_| BF Bute - ITC Sav-ITC Broc-irc =| | JFMon.-iro | | forse) | J. Civil Rico Matters Date: Also complete “Section G” Other Clvil Matters Date: Judgment___.___.___»=___® Judicial Outcome___ OX Amount $ Suspension: Years Months ____. K. Administrative Sanction Date: Subject Description Code Type: Length: . Suspension [[] Permanent Debarment or Injunction Year. Months L. Asset Seizure Date:. Asset Forfeiture 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 Seizures “ Date: Drug Code ® Weight FDIN Do nat indicate $ in Section D O. Child Victim Information Child located / identified Date:_O of obroy PRriving (J Deceased Code ° b6 Social Security No. (if available) b7c Fort ur Subject related fo an LCNfAsian Organized Crime (AOC), Nalian Organized Crime (IOC), Russian/Eastern European, Caribbean, or Nigenan Organized Crime Group = Complete FD-5158, Side 1 Blocks A-E mandatory, F-H as appropriate. Subject related to an OC/Drug organization, a VCMO Program National Gang Strategy targel group, or a VCMO Program Nalional Priority Initiative largel group - Complata FD-515a, Sida 1 Blocks A-C only. x Additional information may be added by attaching another form or a plain sheet of paper for additional entries. « 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. B/lE- MM -(080b2- 207 HOUSE_OVERSIGHT_ 021634