Text extracted via OCR from the original document. May contain errors from the scanning process.
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FD-515 (Rev. 12-19-06) ®@ Accomplishment Report ° Date Prepared 29/0 S
Squad supervisor approval (Accomplishment must be reported and loaded into Date Loaded 20/ O¢
(please initial) ISRAA within 30 days from date of accomplishment) Date Loaders Initials
Investigative Assistance or Technique Used
File Number 1. Used, but did not help 3. Helped, substantially
— PPIy, 5 S/E-MMn—[ow Oez| 2. Helped, minimally 4, Absolutely eesenial
— al For Sub. Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO
Banieuptey Fraud ol | Rate FO aT Rata FO IAT Rate FO \AT Rata FO 1aT b6
Computer Fraud/Abuse | Fin anaiyst | bab riettsun |] [uco-narpack{ | b7C
Corruption of Public Offctal BR Aicconasst | | [Penensore | —_ fli oaver ican] | aE
[Consen won. | [I Potyoraph | ME crisis Neg. Fed] |
RA Squad]
AFOOT | PRCA Re fevsuririsc || [search Warant| Mss top-Locl| |
LEED Pause tu | A Siow vonoy | JMenracs, |_|
a Butte - ITC
Sav - ITC
Poc- ITC
Ft. Mon. - ITC
lee
Td
Eng. Tape Ex. | | swat Team |_|
Teh. ates |_|
[ Evid. Purchaso| IE Phone Tou Reo| |
[isb. bw. xem] | [uco-Groupi]
J. Civil Rico Matters Date:
Also complete “Section G"
Other Civil Matters Date:
F. Conviction
(Federal ([JLocalt [7] Intemational
Conviction Date:
A. Complaint / Information/ indictment
(JFederat [Local {J International
Complaint Date;
Check If Civil Rico Complaint 1 Subject Description Code *(—_)* Judgment ——._——_—__.___*
Judicial Outcome —*%
Information Date: For 6F, G, H-Include Agency Code Amount $
Indictment Date: 5 Petty or 5 aad Suspension: Years Months__
Plea or ria
B, Locate / Arrest State: Judicial District: K. Administrative Sanction Date:
Subject Description Code .
Type: Length:
(Federal [JLocal [[] International :
Subject Priority, OA 4B Oc
G, U.S. Code Violation
Required for sections A, B, F and J Suspension [] Permanent
Locate Date: (Federal Only) A Debarment or
Arrest Date: Title Section # Counts Injunction Year. Months.
(1 Subject Resisted Arrest
(3 Subject Arrested was Armed
L. Asset Seizure Date:.
Asset Forfaiture Date:
CATS # Mandatory
Circle below one of the three asset forfeiture:
Admin, Civil Judicial, or Criminal
oO
. Summons Date:
(Federal [j Locat
. Recovery / Restitution / PELP X
(Federal [Local [1 international
Recovery Date:
Code * v Amount $
Code*__syv = Amount §
Restitution Date:
Do not indicate $ value in Section D
H, Sentence Date: -
M. Acquittal/ Dismissal/ Pretrial Diversion
Sentence Type: *
(Circle one) Date:
Months____
Months.
In Jail: Years,
Suspended: Years
N. Drug Seizures V Date:
(Court Ordered [[] Pretrial Diversion Probation: Years Months___ Drug Code *
Code * ¥ Amount $ Fines: $ <a Code
PELP Date: é Do nat indicate $ in Section D
Code * v Amount $ |. Disruptlon/Dismantlement: Vv
E. Hostages(s) Released Date:,
Disruption Date:
Released by: [1] Terrorist [[] Other
O. Child Victim Information
Child located / identified Date: oof opray
PRuiving _ [Deceased
Dismantlement Date:
Number of Hostages:
Completion of FD-515a Side 2 Mandatory
P, Subject Information - Required for ail blocks excluding block D (Recovery/PELP), blocks E, 1, Land N b6
| | | Race* | Sex | Date of Birth Social Security No. (if available) b7c
oO Subject related to an LCN, Asian Organized Crime (AOC), italian Organized Crime (!0C), Russian/Easlern European, Caribbean, or Nigerian Organized Came Group +
Complete FD-515a, Side 1 Blocks A-E mandatory, F-H as appropriate,
oO Subject related to an OC/Drug organizalion, a VCMO Program National Gang Strategy target group, or a VCMO Program Nalional Priority Initiative target group -
Complata 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,
Serial No. of FD-515
e See codes on reverse side. [|
Y 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.
O/E-MW - '!98062- 2o2
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