G' tLL5. GPO 201G-39S-373 . — — - . _
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 7154-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.._A ra-
Z Medicare. /lepIl31 Insymnee bred, Unreel Hea14hCarr Cord, 11.5 OO.Oe CeSh)
NleitoLa 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