| FD-794                                                                                                                                                                                                      |                                                |                                                                                      |               | (Blank form is Unclassificd//P0U0, but may be classified when filled in) |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------|--------------------------------------------------------------------------------------|---------------|--------------------------------------------------------------------------|-----------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------|---------|--|--|--|
|                                                                                                                                                                                                             | FEDERAL BUREAU OF INVESTIGATION<br>Version 2.0 |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
|                                                                                                                                                                                                             | Revised 03/11/2021                             |                                                                                      |               |                                                                          | PAYMENT REQUEST |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
| routine uses referenced in this notice.                                                                                                                                                                     |                                                |                                                                                      |               |                                                                          |                 | The collection of information on th s form is authorized by 5 U.S.C. 301 (FBI authorized to create and retain agency records) and 28 U.S.C. 530C(bX4) (FBI authorized to<br>use appropriated funds for conduct of its authorized activities). Your Social Security Number is solicited as authorized by E.O. 9397 (Nov. 30, 1943), as amended by E.O.<br>13478 (Nov. 18, 2008). The inform tion sought will be used by the FBI to process your request for an advance payment of funds or request for reimbursement for<br>authorized commercial or source-re atcd expenses. Disclosure of the requested information is mandatory; failure to provide the requested information will delay the<br>processing of your request and may result in its denial. This information is maintained in the FBI Central Records System. Justicc/FBI-002, a description of which can be<br>found at hups://go.fbinet.fbiiDOIOGOLTHIPCLU/PrivacyCivil*A20Lihcrties%20Library/Fomis/FBI002.aspx. This information may be disclosed in accordance with the |                   |         |  |  |  |
| Forfeiture or Drug Related•? Overall Classification of Form•:<br>Cost Code•:                                                                                                                                |                                                |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
| '3540                                                                                                                                                                                                       | No<br>'Unclassified<br>0<br>0<br>Ycs           |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
|                                                                                                                                                                                                             |                                                | Program/Subprogram• (if not listed, rype the 4-5 digital code):                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
| I                                                                                                                                                                                                           |                                                | (RIRI) Violent Crimes Against Children, Violent Crimes Against Children              |               |                                                                          |                 | I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           |                   |         |  |  |  |
|                                                                                                                                                                                                             |                                                | Need help? Use the ENIGMA tool online to confirm correct Fir by case classification. |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
|                                                                                                                                                                                                             |                                                |                                                                                      |               |                                                                          |                 | INFORMATION ABOUT THE REQUESTING EMPLOYEE                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   |                   |         |  |  |  |
|                                                                                                                                                                                                             |                                                | Official Bureau Name: (Last, First, Middle Initial)                                  |               |                                                                          | UE1D•:          | Date of Request•:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           |                   |         |  |  |  |
|                                                                                                                                                                                                             |                                                |                                                                                      |               |                                                                          |                 | 10/07/21                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |                   | 1       |  |  |  |
| Division:                                                                                                                                                                                                   |                                                |                                                                                      | Section/RA:   |                                                                          |                 | UnitiSquad:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                   |         |  |  |  |
| Ncw York                                                                                                                                                                                                    |                                                |                                                                                      | 'NYC' HQ City |                                                                          |                 | C-20                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |                   |         |  |  |  |
|                                                                                                                                                                                                             | r: (include area code)                         |                                                                                      | Case Number:  |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
| E-NY-302757 I                                                                                                                                                                                               |                                                |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
|                                                                                                                                                                                                             |                                                | Waslwill the expense be paid by an alternate employee?                               |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
| O Yes<br>0                                                                                                                                                                                                  | No                                             |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
| Is this a one time non-symbol source payment•?<br>No<br>Yes 0<br>0<br>If an expense was already incurred. was it paid with personal funds?<br>If yes, please select your preferred method of reimbursement: |                                                |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
| CD Yes 0                                                                                                                                                                                                    | No                                             |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
|                                                                                                                                                                                                             |                                                |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
| Justification•:                                                                                                                                                                                             |                                                |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
| This request is for the reimbursement of expenses incurred by the case team through the<br>purchase of meals fora trial witnesses on 06/23/21.                                                              |                                                |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
|                                                                                                                                                                                                             |                                                | To be completed by FINANCE OFFICE ONLY.                                              |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
| Fund:                                                                                                                                                                                                       | Organization<br>Level 2:                       | Program:                                                                             | Sub Program:  | SOC:                                                                     | Sub SOC:        | Description•:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               | \mount :          |         |  |  |  |
|                                                                                                                                                                                                             |                                                |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
|                                                                                                                                                                                                             |                                                |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             | Total Request:    |         |  |  |  |
| Add New Ron<br>Remove Row                                                                                                                                                                                   |                                                |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
| To he completed by FINANCE OFFICE UNIX.                                                                                                                                                                     |                                                |                                                                                      |               |                                                                          |                 |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                   |         |  |  |  |
| BID 1                                                                                                                                                                                                       |                                                | FBI 1:                                                                               |               | Project:                                                                 |                 | User Dimension 4:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           | User Dimension 5: |         |  |  |  |
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| FD-794                                                                                                                                                                                                      |                                                |                                                                                      |               |                                                                          |                 | (Blank form is Unclassificdf/F0U0, but may be classified when filled in)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    |                   | Page of |  |  |  |

FD-794 Version 2.0 Revised 03/11/2021 (Blank form is Unclassificdf/F0U0, but may be classified when filled in)

FEDERAL BUREAU OF INVESTIGATION

PAYMENT REQUEST

## APPROVAL

HQ Only

Reouestor Supervisor:

Next Level Supervisor:

Field Only

supervisor Initials:

SAC/ASAC/AO/SAS:

Procurement Authority:

Signature! Date

Pigitalla4pproved via Sentinel

## FINANCE OFFICE ONLY SETTLEMENT OF ADVANCE

|                                 | Creator<br>FOS Approver |           |       |           |  |
|---------------------------------|-------------------------|-----------|-------|-----------|--|
| Document Number:                | Date:                   | Initials: | Date: | Initials: |  |
| Commitment:                     | P                       |           |       |           |  |
| Obligation:                     |                         |           |       |           |  |
| Advance:                        |                         |           |       |           |  |
| Expense:                        |                         |           |       |           |  |
| Cash Receipt:                   |                         |           |       |           |  |
| Cash Receipt -<br>OTCnet (CRO): |                         |           |       |           |  |
| OTCnet Deposit<br>Ticket II:    |                         |           |       |           |  |