EFTA Document EFTA01305097

ame G' tLL5. GPO 201G-39S-373 . — — - . _ 11)-597 (Rev. 4-13-2015) UNITED STATES DEPARTMENT OF JUSTICE FEDERAL BUREAU OF INVESTIGATION Receipt for Property Case ID: 3)E- Nik4 - 3Dais-71 On (date) Sul & 4, (Name) 0 -e:ff re Eps4t in (Street Address) Q Ea 4 7 154-reei- (City) Nitta tc...k, New it,- lc 100ZI item (s) listed below were: rel. Collected/Seized Received From Returned To Released To Page of Description of Item (s): U.SVir e OC.0 U.S. Pascpor-I- nueether .54667z415 L -N04. Stairs Mitit Soles 050,39.50 0% i. Pass roe 4- Reel Cover/c.cse 1 ent In PPd eq.ce, Vic1/4114 (A tit ce•Pt EAr rers_Cami4ALS C uchtvis.._Ara- Z Medicare. /lepIl31 Insymnee bred, Unreel Hea14hCarr Cord, 11.5 OO.Oe CeSh) Nleit oLa Post--14- aide ,..1;131 cadlni) Reciirs 4- Dtpe.r6104 1-lesielcout Sccercly De+otitc., and Carj-eci,y Recptis4- cr bete.kneci Preperky, Atc • 16 Zeo3T7 1Pc.4 Mack) A 16.52 , Stood NA GSM gi<GMWS Received By: (Signature) •-41 Printed NametTide: Sperj rt / Printed Name/11 C. Received From: (Signature) DNY_GM_00173130 EFTA_(() I94785 EFTA01305097