House Oversight Accomplishment Report Form (FD-515) – No substantive details

f . D. 0 -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¥ O62! Boon Pa acto Drugs im} A Fugitive O Bankruptcy Fraud Cj Computer Fraud/Abuse Oo Corruption of Public Official Money Laundering Sub Invest Asst by FO(s) Asst. FO(s) A B.C. OD. Rate FO Fin,Analyst | | [Aiccrantasss [| ELSUR/T.N |_| Rate FO IAT Consen Mon. Eng. Tape Ex. Legats Asst. | | Evid. Purchase |_| ntrow info A, Complaint / Information/ Indictment (Federal []Local Complaint Date: F, Conviction O Federal C1 Locat Conviction Date:, (J Intemational (1 Intemational Check if Civit Rico Complaint 1 Subject Description Code e (——-)* Information Date: For 6F, G, H-Include Agency Code (1 Felony or (1 Plea or State: (7 Misdemeanor 0 Triai . Judicial District: indictment Date: B. Locate / Arrest (Federal ([JLocal {J International : Subject Priority, OA (7B Oc Locate Date: G. U.S. Code Violation Required for sections A, B, F and J (Federal Only) Title Arrest Date: Section (-) Subject Resisted Arrest (D Subject Arrested was Armed C. Summons Date: (Federal [7 Local D, Recovery / Restitution / PELP X [Federal [JLocal [1 International H. Sentence Date: Recovery Date: Sentence Type: ' : ., e Code v Amount § In Jail: Years Months__ Code * Y Amount $ Months___ Months, Suspended: Years. Restitution Date: _. [] Court Ordered = [[] Pretrial Diversion Probation: Years, Code* ev = Amount $ Fines: $ PELP Date: F Code * ¥ Amount $ I. Disruption/Dismantlement: “ E. Hostages(s) Released Date: Disruption Date: Released by: (] 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. [pen sisters |__| [compuer | | |Phoocover |_| [Consen Mon, | [MB Poyorann || PeusuriFisc | | search Warant| | | ELSUR/T. IN | Show Money fro. Feldsen| | |socass. |_| [swat Teom |_| Tech Agtcuip.| | See [tabi eam] | _[uco-Grow il] —_| es ee 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 J. Civil Rico Matters Judgment. Judicial Outcome. ox 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 Circte below one of the three asset forfeiture: Admin, Civil Judicial, or Criminal Do not indicate $ value in Section D (Circle one) Date: N. Drug Seizures “ Drug Code ® Weight FDIN Do not indicate $ in 0. Child Victim Information Child located /identified Date: ofgofroy Prriving 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 crinins ieassl | ERT Asst. | Ft. Mon. - ITC For, Lang Asst. Non FBI Lab Ex Also complete “Section G" Other Civit Matters Date: M. Acquittal/ Dismissal/ Pretrial Diversion 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 |