EFTA00123447

U.S. Department of Justice

EVIDENCE DISPOSITION DOCUMENT

<table><thead><tr><th colspan="2">NAME OF AUTHORIZING OFFICIAL</th><th>TITLE AND TELEPHONE NUMBER</th><th>DATE</th><th>CASE NUMBER</th></tr></thead><tbody><tr><td colspan="2"></td><td>AUSA</td><td>12-19-24</td><td>2019-010614</td></tr><tr><td>DISPOSITION ORDERED (check one)</td><td colspan="4">DESCRIPTION OF ITEM</td></tr><tr><td>✓ RETURN<br>☐ DESTROY<br>☐ OTHER (specify)</td><td colspan="4">LOG #11<br>Item 1: Daily Forms (cos, kt₃) 7/2/19 → 8/9/19<br>Item 2: Control Center Paperwork 8/9/19 → 8/10/19</td></tr><tr><td colspan="5">EVIDENCE RETURNED</td></tr><tr><td colspan="5">NAME AND SIGNATURE OF SPECIAL AGENT RETURNING THE EVIDENCE</td></tr><tr><td colspan="5"></td></tr><tr><td>NAME OF PERSON RECEIVING EVIDENCE</td><td colspan="4">DATE AND SIGNATURE OF RECIPIENT</td></tr><tr><td colspan="2"></td><td>12/11/24</td><td colspan="2"></td></tr><tr><td colspan="3">ADDRESS</td><td colspan="2">TELEPHONE NUMBER</td></tr><tr><td colspan="3">MDC Brooklyn</td><td colspan="2"></td></tr><tr><td colspan="5">EVIDENCE DESTROYED</td></tr><tr><td colspan="3">METHOD USED</td><td colspan="2">DATE</td></tr><tr><td colspan="3"></td><td colspan="2"></td></tr><tr><td colspan="3">NAME AND SIGNATURE OF PERSON WHO DESTROYED THE EVIDENCE</td><td colspan="2">DATE</td></tr><tr><td colspan="3"></td><td colspan="2"></td></tr><tr><td colspan="3">NAME AND SIGNATURE OF WITNESS</td><td colspan="2">DATE</td></tr><tr><td colspan="3"></td><td colspan="2"></td></tr></tbody></table>

OIG FORM III – 234/4 (02/13/09)