) Date Prepared if Z
(please initial) ISRAA within 30 days from date of accomplishment)
5 Vv. 12-19-06) @ Accomplishment Report ‘Squad supervisor approval (Accomplishment must be reported and loaded into ; Date Loaded
Date Loader’s Initials
Investigative Assistance or Technique Used
eee aot File Number 4. Used, but did not help 3. Helped, substantially , E-MM—- jf afoez 2. Helped, minimally 4. Absolutely essential
For Sub, Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO
Rate FO laT Rate FO IAT Rate FO 1A
[Fin aneiyst | Piva rietasun | | Frecetaesc | | [Pores | cepa || eos 1
PL corsenitn |
ce oe SO Score
|__| socasst. HB Butte - TC
Bswattoom | TM saverc |
Bankruptcy Fraud Computer Fraud/Abuse C Corruption of Public Official (0 Money Laundering O Sub Invest Asst by FO(s)
Rate FO IAT
. juco-NatBeck| NCAVCY Vi-CAP ; coin intl Asst] | . CART
HevstsNog-tocal| |
RA A.B. OC, De
Evid. Purchase Phone Toll Rec Ft.Mon.-1TC | [iN OFCICID Inf(CW Info UGCO - Group | For. Lang Asst. | | jprp | Lab, Div, Exam UCO - Group II NonFBitabex} | fo |
J. Civil Rico Matters Date: Also complete “Section G”
Other Civil Matters Date:
F. Conviction (Federal Di Local
Conviction Date:
A. Complaint / Information/ indictment
(}Federat [Local [7 International Complaint Date:
(2 Intemational!
Check if Civil Rico Comptaint. (1 Subject Description Code *(__)» Judgment — —— na” ; For 6, G, Heinclude A Bnd Judicial Outcome. _ OX Information Date: or OF, G, H-Inciude Agency Cade Amount $ indictment Date: 5 Palony or 5 al Suspension: Years Months Plea or Tria
B. Locate / Arrest State: Judicial District:
(Federal [local [International - Subject Priority: TTA CIB [1c
K. Administrative Sanction Date: Subject Description Code a Type: Length:
G. U.S, Code Violation
__ Required for sections A, B, F and J Suspension [[] Permanent Locate Date: + (Federal Only) Debarment or Arrest Date: Title Section # Counts Injunction Year Months.
(i Subject Resisted Arrest [ Subject Arrested was Armed
L. Asset Seizure Date: Asset Forfeiture Date: CATS # Mandatory —_____9/»_ ____ Circle below one of the three asset forfeiture:
Admin, Civil Judicial, or Criminal
Cc. Summons Date: (Federal (7 Local
. Recovery / Restitution / PELP X []Federal [JLocal [J International Recovery Date:
Code * v Amount $ Code*__sy Amount $
Restitution Date:
Do not indicate $ vatue in Section D
H, Sentence Date:
Sentence Type: . M. Acquittal/ Dismissal/ Pretrial Diversion
(Circle one) Date:
Months. Months
In Jail: Years
Suspended: Years.
N. Drug Seizures “ Date:
(Court Ordered 1] Pretrial Diversion Probation: Years, Months_____ Drug Code ° “ Code * v Amount $ Fines: $ a Code PELP Date: i Do not indicate $ in Section D Code* ov =Amount $ |. Disruption/Dismantlement:
. Hostages(s) Released Date:
Disruption Date:
0. Child Victim Information Released by: CTerrorist [7] Other Child located / identified Date: by 29 OY
Btiving _ (Deceased
Dismantlement Date: Number of Hostages:
Completion of FD-515a Side 2 Mandatory
P, Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks &, |, L and N
ee ees es ee ee ly:
visdOns 0: . 0 Subject related fo an LCN, Asian Organized Crime (AOC), Ilalian Organized Crime (IOC), Russian/Eastern European, Caribbean, or Nigerian Organizad Cnme Group - Completa FD-515a, Side 1 Blocks A-E mandatory, F-H as appropriate,
oO Subject ralatad to an OC/Drug organization, a VCMO Program National Gang Strategy targa! group, or a VCMO Program National Priority Initiative targel group « Completa 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. erie) NG BLE S15
e See codes on reverse side. PE
¥ 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.
AlE-NY -—]06062- | 78
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HOUSE_OVERSIGHT_021576