f . D.
0
-515 (Rev, 12-19-06)
“Squad supervisor approval (please initial)
Accomplishment Report
(Accomplishment must be reported and loaded into ISRAA within 30 days from date of accomplishment)
Accomplishment involves: (check all that apply)
4. Used, but did not help 2. Helped, minimally
File Number (S/E-MIN-16¥ O62!
Boon Pa acto
Drugs im} A Fugitive O Bankruptcy Fraud Cj Computer Fraud/Abuse Oo Corruption of Public Official Money Laundering
Sub Invest Asst by FO(s)
Asst. FO(s) A B.C. OD.
Rate FO
Fin,Analyst | |
[Aiccrantasss [|
ELSUR/T.N |_|
Rate FO IAT
Consen Mon.
Eng. Tape Ex. Legats Asst.
| | Evid. Purchase |_| ntrow info
A, Complaint / Information/ Indictment
(Federal []Local Complaint Date:
F, Conviction O Federal C1 Locat Conviction Date:,
(J Intemational (1 Intemational
Check if Civit Rico Complaint 1 Subject Description Code
e (——-)*
Information Date: For 6F, G, H-Include Agency Code (1 Felony or
(1 Plea or State:
(7 Misdemeanor
0 Triai .
Judicial District:
indictment Date:
B. Locate / Arrest (Federal ([JLocal {J International :
Subject Priority, OA (7B Oc Locate Date:
G. U.S. Code Violation Required for sections A, B, F and J (Federal Only)
Title
Arrest Date: Section
(-) Subject Resisted Arrest (D Subject Arrested was Armed
C. Summons Date: (Federal [7 Local
D, Recovery / Restitution / PELP X
[Federal [JLocal [1 International H. Sentence Date: Recovery Date: Sentence Type: ' : ., e Code v Amount § In Jail: Years Months__ Code * Y Amount $
Months___ Months,
Suspended: Years.
Restitution Date: _. [] Court Ordered = [[] Pretrial Diversion
Probation: Years,
Code* ev = Amount $ Fines: $ PELP Date: F Code * ¥ Amount $ I. 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
P, Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks E, f, Land N
Oo Subject related to an LCN, Asia
Org: Complete FD-515a, Side 1 Blocks A-E mandatory, F-H as appropriate,
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. e See codes on reverse side.
[pen sisters |__| [compuer | | |Phoocover |_| [Consen Mon, | [MB Poyorann || PeusuriFisc | | search Warant| | | ELSUR/T. IN | Show Money fro. Feldsen| | |socass. |_| [swat Teom |_| Tech Agtcuip.| | See [tabi eam] | _[uco-Grow il] —_|
es ee
jagzed Crime (AOC), Italian Organized Crma (10C), Russian/Eastern European, Caribbean, or Nigerian Organized Crime Group -
Investigative Assistance or Technique Used 3. Helped, substantially
4. Absolutely essential For Sub, Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO
IAT Lab. Field Sup
J. Civil Rico Matters
Judgment. Judicial Outcome. ox
Amount $ Suspension: Years
K. Administrative Sanction Date:
Subject Description
Type: Length: Suspension [[] Permanent Debarment or Injunction Year Months
L. Asset Seizure Date:
Asset Forfeiture D CATS # Mandatory
Circte below one of the three asset forfeiture: Admin, Civil Judicial, or Criminal Do not indicate $ value in Section D
(Circle one) Date:
N. Drug Seizures “
Drug Code ® Weight
FDIN
Do not indicate $ in
0. Child Victim Information
Child located /identified Date: ofgofroy
Prriving
oO Subject relaled to an OC/Drug organization, a VCMO Program National Gang Sirategy target group, or a VCMO Program National Priority tnitialive target group -
Rate FO \AT
|| Juco-Natacr| | Be crinins ieassl | ERT Asst.
|
Ft. Mon. - ITC For, Lang Asst. Non FBI Lab Ex
Also complete “Section G"
Other Civit Matters Date:
M. Acquittal/ Dismissal/ Pretrial Diversion
Date Prepared 29 Date Loaded Date Loader's Initials
Rate FO IAT
| Vict Witn Coor | Coor
10 Wanted Flyer
[eee a
Date:
Months__
Code *
ate:
Date:
Code °
Section D
[J Deceased
Social Security No. (if available)
Serial No. of FD-515
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,
B/E-MM- 108062 - 20%
b6 b7C
HOUSE_OVERSIGHT_021636 |