FD-340c(4-11.03)

FD-340c(4-11.03) File Number §)1)- Ntl 62.1571 Field Office Acquiring Evidence Serial # of Originating Document Date Received From (Name of Contributor/Interviewee) (Address) (City and State) By To Be Returned 0 Yes Q No Receipt Given 0 Yes El No Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) • Federal Rules of Criminal Procedure o Yes [21 No Federal Taxpayer Information (FTI) I:I yes 10 No Title: Reference: (Communa:anon Enclosing Material) Description: 0 Original notes re interview of It< ius 'FY eps-itin re tvrhed im lam (tor EFTA00257793 FD-597 (Rev. 4-13-2015) Page of Case ID: UNITED STATES DEPARTMENT OF JUSTICE FEDERAL BUREAU OF INVESTIGATION Receipt for Property On (date) item (s) listed below were: Collected/Seized ecoived From Returned To Released To (Name) (Street Address) (City) Description of Item (9): 604 &ve's 1.,;( et/Se 00000 a 56>'7ii L4frn; -Nem- P14412 uro is 15-O IttS 6tss/t/7 Q. (do