FD-340 (Rev. 4-11.03)

FD-340 (Rev. 4-11.03) File Number 3 1 (-• /KM I 5(t, P- Field Office Acquiring Evidence Serial H of Originating Document Date Received From " ?CI 40 3/ / P/.2o / (Name of ConuibutorAntavicivec) (Address) By Sit (City and State) To Be Returned 0 Yes g No Receipt Given @ Yes 0 No Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) Federal Rules of Criminal Procedure 0 Yes No Federal Taxpayer Information (FT!) 0 Yes 9 -No The: Reference: (Communication Enclosing Material) Descriptions 0 Original notes re interview of ao rea4,-.,1 e ir7 Pt 1 ho- n7 EFTA00156507 FD-S97 (Rev 8-11-94) Page f. • • • • File # S. GPO. 2004.337."4 9:: la UNITED STATES DEPARTMENT OF JUSTICE FEDERAL BUREAU OF INVESTIGATION Receipt for Property Received/Returned/Released/Seized 31E- »•1n- /0spb a. • I of On (date) 0.07/20// item(s) listed below were: a Received From 0 Returned To El Released To Seized (Name) C (Street Address) (