HOUSE_OVERSIGHT_021596

FD-515 (Rev. 12-19-06) Accomplishment Report e Date Prepared O/2: of f 3

“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

Accomplishment involves: (check all that apply)

Investigative Assistance or Technique Used

File Number 1, Used, but did not hetp 3. Helped, substantially = = 2. Helped, minimali 4, Absolutely essential Drugs E-mmM-ioxoez Pp y ly

| A Fugitive oO Bankruptcy Fraud 0 Computer Fraud/Abuse Corruption of Public Official [1] , Money Laundering Sub invest Asst by FO(s)

For Sub, invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO Rate FO IAT Rate FO IAT

JAT Rate FO

[Faves |_| B Arconasss |_| _| [conpuer |_|

Asst. FO(s) eLsur/Fisc}| | ‘|Search Warrant] MME Crisis Nog.- Local Asset Fort Prog A. B.C, D. ELSUR /T. Il Show Money BerrAsst. | [MMMM For! Support Pro}

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free | Pd

Tech. AgiEquip.

BED Legats Asst. |_| Evid. Purchase Phone Toll Rec

J. Civil Rico Matters Date: Also complete “Section G”

Other Civit Matters Date:

|| = | | | |socasst | | m_ =

F. Conviction O Federal (C)Local (7) International Conviction Date:,

A. Complaint / Infermation/ Indictment

(Federal [JLocal {7 Intemational Complaint Date:

Check if Civil Rico Complaint C1] Subject Description Code *(_)* Judgment —_ ___.__ ___* For 6F, G, H-Include A Soil Judicial Outcome___ . PX Information Date: or GF, G, H-Include Agency Co ° Amount $ Indictment Date: = Felony or 5 al Suspension: Years Months Plea or Trial

B. Locate / Arrest State: Judicial District:

Cl Federat [JLocal {international - Subject Priority. OA 1B Oc

K. Administrative Sanction Date: Subject Description Code . Type: Length:

G. U.S. Cade Violation

Required for sections A, B, F and J Suspension ([] Permanent Locate Date: (Federal Only) : Debarment or Avast Date: Title Section # Counts Injunction Year. Months

([] Subject Resisted Arrest (1 Subject Arrested was Armed

L. Asset Seizure Date:, Asset Forfeiture Date: CATS # Mandatory ___ Circle befow one of the three asset forfeiture:

Admin, Civil Judicial, or Criminal

Cc. Summons Date: (Federal [J Local D. Recovery / Restitution / PELP X (DFederal [Local [7 Intemational Recovery Date: Code * vy Amount $ Code*__ v= Amount $ Restitution Date:

Do not indicate $ value in Section D

H. Sentence Date:

Sentence Type: e M. Acquittal! Dismissal/ Pretrial Diversion

(Circle one) Date:

Months___-_ Months___.

In Jail: Years

Suspended: Years.

N. Drug Seizures “Date:

Oi Court Ordered ((] Pretrial Diversion Probation: Years, Months____ Drug Code ° . Code * v Amount $ Fines: $ iti Code PELP Date: . Do not indicate $ in Section D Code * v Amount $ |. Disruption/Dismantlement:

E. Hostages(s) Released Date:.

Disruption Date: Released by: [[] Terrorist [7] Other

0, Child Victim Information Child located / identified Date: b/ 20 oY

Buiving _ {Deceased

+ 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 &, |, Land N

oO Subject related to an LCN, Asian Organized Crime (AOC), Italian Organized Crime (!0C), Runsian/Eastern European, Caribbean, or Nigenan Organized Crime Group - Completa FD-515a, Side 1 Blocks A-E mandatory, F-H as appropriate.

oO Subject related to an OC/Drug organization, a VCMO Program Nalional Gang Stralegy target group, or a VCMO Program National Priority Initiative target group « Complete FD-515a, Side 1 Blocks A-C only, 5

x Additional information may be added by attaching another form or a plain sheet of paper for additional entries. stig Ngo TD RIe

e See codes on reverse side, {SY

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,

BIE - MU- [08062 ~ 13%

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HOUSE_OVERSIGHT_021596