House Oversight Form (FD-515) Detailing Reporting Procedures and Data Fields

~ Vv. 12-19-06) Squad supervisor approval Accomplishment Report (Accomplishment must be reported and loaded into Date Prepared OH 29] oO 4 b6 ao Date Loaded (please initial) ISRAA within 30 days from date of accomplishment) Date Loader’s Initiats alo : b7E ji - Investigative Assistance or Technique Used er eti ioe File Number 4. Used, but did not help 3. Helped, substantially EC-MM-(oKoez 2. Helped, minimally 4. Absolutely essential For Sub. Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO AT ___Rale FO_IAT_—_—=Rale FO__tAT_—aRala FO. Computer Fraud/Abuse Fcaove | WiMiss ress] | Juco-narsee] | Corruption of Public Official CI BE AircrattAsst. | | [PonRegisters | MMIBNCAVC/vicap| [lM 10 Wanted Flyer Money Laundering | Computer | | | Photocover | MM Cris intet Asst] | | Consen Mon. | JMB Powverann | MMBorisis Nog Feal | Asst. FO(s) ecsursFisc| | '| search Warrant fie Criss Nog. Local PE crc Ficase. | | [socass. | [iBautte-irc ”~SCSY Ens. tepo ex | “TM swatteam | FM sav-irc | Legats Asst | MM toch. Agitquip,| MM Poc-tro |_| |__| Evid. Purchaso| [III Phone Tot Rec MMFt.Mon.-iT | | [Jinrowino [| [uco-Groupi | Fox tenoasst | fl rre | tab.Di.exam| | uco-Group| [i Nonratvebex? | fo A. Complaint / Information/ Indictment F. Conviction J. Civil Rico Matters Date: (lFederal []Loca! (] International (Federat [JLocal [1] International Also complete “Section G” Complaint Date: Conviction Date: Other Civil Matters Date: : sgt e Check if Civil Rico Complaint. £1] Subject Description Code +(___.}* se i . — eee esa Judiclal Outcome____§___ OK i : or 6F, G, H-Include Agency Code ; Information Date: gency Amount $ Indictment Date; L Felony or [) Misdemeanor Suspension: Years Months (Plea or OD Trial B. Locate / Arrest State: Judicial District: K. Administrative Sanction Date: CiFederal [Local [1 internationat « Subject Description Code ; _ G, U.S, Code Violation Type: Length: Subject Priority: A OB Oc Required for sections A, B, F and J C] Suspension [1] Permanent Locate Date: (Federal Only) , J Debarment or Arrest Date: Title Section # Counts LJ} Injunction Year. Months. ( Subject Resisted Arrest L. Asset Seizure Date: (1 Subject Arrested was Armed Asset Forfeiture Date: CATS # Mandatory —____SESESESeee C. Summons Date: Circle below one of the three asset forfeiture: (Federal [J Local Admin, Civil Judicial, or Criminal Do not indicate $ value in Section D D. Recovery / Restitution / PELP X HL Sentonee Dat new SMR Sestioinl Federal Local intemati s pentence Dates ° 0 0 O allan s Tvoe: M. Acquittal/ Dismissal/ Pretrial Diversion Recovery Date: entence Type: ' e (Circle one) Date: ade vf ARGORE & In Jail: Years. Months___ ) Gade * ¥ Amount § Suspended: Ye Months N. Di Sei ¥ Dat spe: H ja6s. a H Restitution Dates P THOSE RUSS ae [Court Ordered {[] Pretrial Diversion Probation: Years Months Drug Code * ; Code * v Amount $ Fines: $ Weight Code PELP Date: Fely ate: : Do not indicate $ in Section D Code*_ sv =Amount $ |, Disruption/Dismantlement: “ E. Hostages(s) Released Date: . O. Child Victim Information Disruption Date: b Released by; [] Terrorist [J] Other Child located / identified Date: od Dismantlement Date: , Number of Hostages: iu i D ed Completion of FD-515a Side 2 Mandatory mang [} Deceas 2 P, Subject Information - Required for all blacks excluding block D (Recovery/PELP), blocks &, |, L and N b6 [Race [Ser For Indictments/Convictlons only: Social Security No. (if available) b7Cc oO Subject related 1o an LCN, Asian Organized Crime (AOC), Italian Organized Cima (1OC), Russian/Eastern European, Caribbean, or Nigenan Organized Cnme Group + Completa FD-515a, Side 1 Blocks A-E mandatory, F-H as appropriate. Subject related to an OC/Drug organization, a VCMO Program National Gang Strategy target group, or a VCMO Program National Priority Inilialive target group - Complete FO-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. Serial No. of FD-515 ¥ 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-MU- (08062- | 90 HOUSE_OVERSIGHT_021600