FD-515 (Rev, 12-19-06) * Accomplishment Report e Date Prepared 29/08
‘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
"O62! 2. Helped, minimally 4, Absolutely essential Drugs [S/ e
For Sub. Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO
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O A Fugitive 0 Bankruptcy Fraud O Computer Fraud/Abuse C] Corruption of Public Official Money Laundering Sub Invest Asst by FO(s)
Rate FO
Rate FO Rate FO tA Rate FO aT
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J. Civil Rico Matters Date: Also complete "Section G”
Other Civil Matters Date:
F, Conviction (Federal ([Jkocal [7 Intemational Conviction Date:
A. Complaint / Information/ indictment
(JFederat [Jkocal [1] Intemational Complaint Date:
Check if Civil Rico Complaint O Subject Description Code *(__* SET aes aa For 6E G, HeInclude A Bud Judicial Outcome__._-_ OX Information Date: or Or, G, M-Incluae Agency Co ° Amount $ Indictment Date: [1 Felony or [J Misdemeanor Suspension: Years Months__ (Plea or 0 Trial
B. Locate /Arrest State: Judicial District:
[Federal [JLocat [7 International - Subject Priority: TIA 8 (Oc
K. Administrative Sanction Date: Subject Description Code . 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
(_] Subject Resisted Arrest (1D Subject Arrested was Armed
L. Asset Seizure Date: Asset Forfeiture Date: CATS # Mandatory EEE Circle below one of the three asset forfeiture:
Admin, Civil Judicial, or Criminal
Cc. Summons Date: (Federal [[] Local D. Recovery / Restitution / PELP X (0 Federal D)Local [7] International Recovery Date: Code * vy Amount $ Code*__ sv = Amount $ Restitution Date:
Do not indicate $ value 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 Vv Date:
(Court Ordered {[] Pretrial Diversion Probation: Years Months____. Drug Code * Code*___sy = Amount $ Fines: $ . eo aie PELP Date: y Do not indicate $ in Section D Code * Y Amount $ |, Disruption/Dismantlement: “ .
E. Hostages(s) Released Date:
. Disruption Date: Released by: (J Terrorist (7) Other
0. Child Victim Information Child located / identified Date:_O off oproy Dismantlement Date:
Phriving _ (Deceased
Number of Hostages: Completion of FD-515a Side 2 Mandatory
P, Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks E, |, Land N
(a a a cee eee eee es ee
Ol Subject related to an LCN, Asian Organized Crime (AOC}, italian Organized Cnme (1OC), Russian/Easiern European, Caribbean, or Nigerian Organized Crime Group - Complete FD-5152, Side 1 Blocks A-E mandatory, F-H as appropriate,
oO Subject related to an OC/Drug organization, a VCMO Program National Gang Stralegy targot group, or a VCMO Program Nallonal Priority Initlalive target group - Complete FD-515a, Sida 1 Blocks A-C only.
x. Additional information may be added by attaching another form or a plain sheet of paper for additional entries. Serial Mo; OLFD-516
e See codes on reverse side. L —C—sSYO
¥ 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-MM - (08062-2049
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HOUSE_OVERSIGHT_021638