Complaint Form

Complaint Form FD-71 (Rev. 4-13-92) NOTE: Hand print names legibly; handwriting amisfactory for remainder. Indite. O Neptive O See below Subjeeth name and alien» i . g r 4 3 t p 5 4 e : n t - Character drue I S ' b e l k 6 f c ( p V C L : C ' \ C a s a t Present Soma • - - - Complaint received ErTelapboric Data ilmi Addl.«. of Subject Comilla ntlr address and telephone number (v,/,V6 *MAO/ \ Race sr. a Rene Sex O Male Height Hair Build 'N•., Birth Date and Birthplace Age D Female Weight Eyes Complexion • Social Security Number Scam marked other data Facts of complaint eXPA .41 QS Sr '‘ ..k '5\,..0 't s A (-X & Cop,p\M;el €'44 444.-\ DAN -k- a*. 4' rk ./t..1C42-5 A \" \ 42 r -Ses-arS. P. ....5, v.. (11-5 n 1-\..,- ,),....5 Pas..". -''...\ (1 /4..k. L". ,9cAs.- .*P 5}e:,,-1 544 ,2 .k. ?1,..1,,,,, ....„3,k Iksay..A-mLs <2,4 ;5Ac,,e,... \<2;.34. it, N.,..-..›,:t -stA. -Kt, , .,.„,,s. -t, f>z ,..k 6.1.,..,- , CI' s{ '',,‘ A..\ ,,,,,, e k.,-,A,2_ •(-44.c.e-,>. \--.. •k-A„\S/2 ;(_\,,,sz'S 'SASS 4-\ -St,N;‘,..x-..‘ ,5, p.t.c( , ps4 E ins ;\ No lr, (:)- (7 / GAO - A*1 6 ec._1,....t. LN "Sc \,,2 k.e.% 4,-,7›,,e. 4\.,.)k \',\g_. . • -p\...\-bs 1\.2 w;\\--- ‘,..,(..› -\,e_c.- \-\,,,se... 0 7 C —.'2° I — b p_ it)iiq -5,?\,- E. Do mt./rite in Mi. mom. ,i clia=1) - 3y 3 I /4/4' 1.111 Complaint maimed by) CK STAMP EFTA00156622