FD919(RmA645-2M3) • FEDERAL BUREAU OF INVESTIGATION Precedence: ROUTINE Date: 08/08/2006 To: Miami From: Miami PB2/Palm Beach County Resident Agency Contact: Twiler Smith, (561) 822-5932 Approved By: Ortiz Eliasib Jr Drafted By: Smith Twiler Case ID #: 31E-MM-108062 (Pending) 188E-MM-105207-C (Pending) Title: VICTIM NOTIFICATION FORM Synopsis: To document victim information. Please refer to the Victim Notification System for the additional pertinent information on the following victims: Details: VnsCase#: CAgtName: PContact: BusName : BusEIN : BusAcct : VicFirN : VicMidN : VicLastN: SSAN : VicDate VicDOD : VicMinor: DOB Race Sex 31E-MM-108062 Guardian 20060725 Y 19900513 F Reference: 31E-MM-108062 Serial 1 `2")-efir5 9\1 3 /6- film /07 a -/p CONFIDENTIAL 3501.047-007 Page I of 3 EFTA_00057793 EFTA01245638 To: Miami From: Miami Re: 31E-MM-108062, 08/08/2006 Addr Addr2 City : State : Country : Zip Email : HPhone : Fax VWrkAddr: VWrkadd2: VWrkCity: VWrkSt : VWrkCtry: VWrkZip : WEmail : WPhone : WFax : VicPager: NOKFirN : NOKMidN : NOKLastN: NOKRel : NOKAddr : NOKAddr2: NOKCity : NOKState: NOKCtry : NOKZip NOKHEmal: NOKWEmal: NOKHPho : NOKWPho : NOKHFax : NOKWFax : NOKPager: GrdFirN : GrdMidN GrdLastN: GrdRel : GrdAddr : GrdAddr2: GrdCity : GrdState: GrdCtry : GrdZip GrdHEmal: GrdWEmal: GrdHPho : 2 CONFIDENTIAL 3501.047-007 Page 2 of 3 EFTA_00O57794 EFTA01245639 F To: Miami From: Miami • Re: 31E-MM-108062, 08/08/2006 GrdWPho : GrdWFax : GrdWFax : GrdPager: PropRet : N TotLoss : 000000000 Lang. : EN Disable : • • CONFIDENTIAL 3501.047-007 Page 3 of 3 EFTA_00057795 EFTA01245640