Accomplishment Report
(Accomplishment must be reported and loaded into ISRAA within 30 days from date of accomplishment)
D-515 (Rev. 12-19-06) Quad supervisor approval (please initial)
4. Used, but did not help 2, Helped, minimally
Eng. Tape Ex. | |
Bankruptcy Fraud Rate FO IAT Rate FO IAT Rate FO IAT Rate FO IAT Corruption of Public Official Aircraft Asst. | [PenRegisters | | Bcavervicap| | Money Launeeting BB compuicr [| Photo cover | EM cinms netass| MB sare | |__| onsen mon || [crisis Neo-Fecl_ MCART Asst. FO(S) | esunvrisc| | [search warrant] (IMME isis ton Locat| II Asset Fort Prog
Evid, Purchase _ InffCW Info
Lab. Div. Exam
F, Conviction (7 Federal C] Local
Conviction Date:
A. Complaint / Information/ indictment
CJFederal [Local Complaint Date:
Check if Civil Rico Complaint C1
(7 International (71 Intemationa!
Subject Description Code ‘Cie For 6F, G, H-Include Agency Code
(Felony
(Plea State:
information Date: or ([] Misdemeanor or 0 Trial
Judicial District:
Indictment Date:
B. Locate / Arrest (Federal (Local
Subject Priority: [A ([]8 Locate Date:
(7 Internationat -
tic
G, U.S. Cade Violation Required for sections A, B, F and J (Federal Only)
Title Section # Counts
Arrest Date: (1 Subject Resisted Arrest (ZF) Subject Arrested was Armed
Cc. Summons Date: (i) Federat [7] Local
D, Recovery / Restitution / PELP X (Federal [Local [J International Recovery Date: Code ® vy Amount $ Code*.__y Amount $ Restitution Date: a [1 Court Ordered [[] Pretrial Diversion
Code*_ v= Amount $ PELP Date: Code *
H. Sentence Date: Sentence Type:
Months. Months___. Months___
In Jail: Years.
Suspended: Years
Probation: —_- Years.
Fines: $
¥ Amount $ L Disruption/Dismantlement: “
E. Hostages(s) Released Date: . . Disruption Date:
Released by: [] Terrorist [7 Other Dismantlement Date: Number of Hostages: ‘ Completion of FD-515a Side 2 Mandatory Ey
P, Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks E, !, Land N
Dat¢ of Birth Social Security No. (if available)
‘an Organized Crime (ACC), Ilalian Organized Crime (1OC), Russian/Easlern European, Caribbean, or Nigerian Organized Crime Group -
ne:
Subject related to an LGN, Ad Complete FD-518a, Side 1 Blocks A-E mandatory, F-H as appropriate,
Subject related to an OC/Drug organization, a VCMO Program National Gang Stralagy target group, or a VCMO Program Nalionat Priority Inilialive targel group
Complale 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. e See codes on reverse side,
v 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.
3/6-
Investigative Assistance or Technique Used
For Sub. Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO
Eng. Field Sp.| | | soaAset.
Swat Team
Phone Toll Rec
| [veo creuet | [[uc0-cruoin|
J. Civil Rico Matters Date:
Date Prepared C129 Date Loaded __7 | F0/ O& be
Date Loader’s Initials
3. Helped, substantially 4, Absolutely essential
Bexne-tro |
ewe |_| re BB Fionve [| ionFariaoes| |
TFOS/CTD
InfraGard/CyD OFC/CID
Also complete “Section G”
Other Civil Matters Date: Judgment Judicial Outcome. re ee Amount $
Suspension: Years
ex
Months
K. Administrative Sanction Date: Subject Description Code Type: Length: Suspension [5] Permanent Debarment Injunction L. Asset Seizure Date:, Asset Forfeiture Date: CATS # Mandatory
Circle below one of the three asset forfeiture: Admin, Civil Judicial, or Criminal
or Year. Months.
Do not indicate $ value in Section D
M. Acquittal/ Dismissal/ Pretrial Diversion
(Circle one) Date:
N. Drug Seizures ~ Date:
Drug Code © Weight FDIN
Do not indicate $ in Section D
O. Child Victim Information Child located / Identified Date: b/ 20) oy
Ktiving (1) Deceased
Code ®
Serial No. of FD-515
UY ~ (98062-/90)
HOUSE_OVERSIGHT_021580