ev. 12-19-06) © Accomplishment Report @ Date Prepared oe of
‘Squad supervisor approval (Accomplishment must be reported and loaded into : Date Loaded / &
(please initial) ISRAA within 30 days from date of accomplishment) Date Loader’s Initials |
Investigative Assistance or Technique Used
File Number {. Used, but did not help 3. Helped, substantially o E-MMN-[oKvocz 2. Helped, minimally 4, Absolutely essential ial For Sub. invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO Bankruptey Fraud | a Rate FO IAT Rate FO IA Rate FO 1A Rate FO IAT
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A. Complaint / Information/ Indictment F. Conviction J. Civil Rico Matters Date:
(CiFederal ([JLocat [International []Federal []Local [7 Intemational Also complete “Section G” Complaint Date: Conviction Dates Other Civil Matters Date:
Computer Fraud/Abuse O Corruption of Public Official Money Laundering
Sub Invest Asst by FO(s)
Asst, FO(s) A B. CG. Dz.
Viet-Witn Coor 10 Wanted Flyer
OFC/CID
Check if Civil Rico Complaint [1] Subject Description Code *{—~j Judgment... Judicial Outcome - °x
Amount $ Suspension: Years Months
Information Date: For 6F, G, H-Include Agency Code (Felony or ( Misdemeanor [Plea or 0 Trial B, Locate / Arrest State:_________ Judicial District: _____. , K. Administrative Sanction Date:,
[Federal [Local [] Internationat- ° Subject Description Code G. U.S, Code Violation Type: Length:
Subject Priority A OB [1c Required for sections A, B, F and J se H Siepemien & | Paanaient
Indictment Date:
LocateDate: | (Federal Only) Debarment or Arrest Date: Title Section # Counts Injunction ——_Year. Months (1) Subject Resisted Arrest err nel _ L. Asset Seizure Date:.
(1 Subject Arrested was Armed Asset Forfeiture Date: ———— ee TT CATS # Mandatory
Cc. Summons Date: Circle below one of the three asset forfeiture: (O Federat [[] Local Admin, Civil Judicial, or Criminal
Do not indicate $ value in Section D D. Recovery / Restitution / PELP X o Rat indicate Salven Section
‘ H. Sentence Date: Federal Local International a Fiat O O fone! Sentence Type: M. Acquittal/ Dismissal/ Pretrial Diversion ecovery Date: f ' ' Code * v Amount $ Code*__s vy =Amount $ Restitution Date: (Court Ordered = [[)] Pretrial Diversion Probation: = Years______ Months__ Drug Code * - Code * Y Amount $ ' Fines: $e te ode PELP Date: . Do not indicate $ in Section D Cede * ¥ Amount $——______. |. Disruption/Dismantlement: ~“ E, Hostages(s) Released Date:______ Disruption Date: O. Child Victim Information Released by: [1 Terrorist [1] Other Child located / identified Date: by 20 oX¥ Dismantlement Date:
Number of Hostages: ___ Wu i D id Completion of FD-51a Side 2 Mandatory mang . [Beoease
ey
(Circle one) Date:
In Jail: Years... Months,
Suspended: Years___.___._ Months____ N. Drug Seizures “ Date:
P. Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks E, f, Land N | | || Race* | Sex | Date of Birth Social Security No. (if available)
Leth { related to an LCN, Asian Organized Cama (AOC), Italtan Organized Cnme ({0C), Russian/Eastern European, Caribbean, or Nigerian Organized Crime Group - Complete FD-518a, Side 1 Blocks A-E mandatory, F-H as appropriate,
Subject relatad to an OC/Drug organization, a VCMO Program National Gang Slralegy targel group, or a VCMO Program National Priority Initiative targel group « Complete FO-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. pedal Norolneete « 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.
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HOUSE_OVERSIGHT_021578