EVIDENCE CUSTODY DOCUMENT

# OFFICE

| OFFICE | CASE # | LOG # | DATE AND TIME OF SEIZURE |
| :--- | :--- | :--- | :--- |
| 19160 | 2019-010614 | 4 | 8/13/19 1600AM |

# PROPERTY SEIZED FROM

| PROPERTY SEIZED FROM | LOCATION OF SEIZURE |
| :--- | :--- |
| | MOP mcc |

# ITEM

| ITEM | DESCRIPTION OF THE PROPERTY SEIZED |
| :--- | :--- |
| $\textcircled{1}$ | 30 Minute Round Count Street
8/10/19 8/18/19 8/19/19 |

# NAME AND SIGNATURE OF WITNESS

NAME AND SIGNATURE OF SEIZING SPECIAL AGENT

# CHAIN OF CUSTODY

| ITEM | DATE/TIME | RELEASED BY | RECEIVED BY | PURPOSE |
| :--- | :--- | :--- | :--- | :--- |
| 1 | 8/13/19 16:55 | | | Evidence Storage PAGE |

OIG FORM III – 234/1 (04/23/07)

EFTA00123392