U.S. Department of Justice

EVIDENCE CUSTODY DOCUMENT

Office of the Inspector General

# OFFICE

| CASE # | LOG # | DATE AND TIME OF SEIZURE |
| :--- | :--- | :--- |
| N4C0 | | August 11, 2019 - 10:49 |

# PROPERTY SEIZED FROM

| LOCATION OF SEIZURE |
|--------------------|
| SIS MCC NY          |
| SIS MCC NY          |

# ITEM DESCRIPTION OF THE PROPERTY SEIZED

## #1
HP ELITE DESK 800 SERIAL #2UA4381YNJ

## #2
HP ELITE DESK 800 SERIAL #2UA4381MW

# NAME AND SIGNATURE OF WITNESS

# SPECIAL AGENT

# SEE ATTACHED

# CHAIN OF CUSTODY

| ITEM | DATE/TIME | RELEASED BY | RECEIVED BY | PURPOSE |
| :--- | :--- | :--- | :--- | :--- |
| 1+2 | 8/11/19 10:47A | | | Evidence |
| 1+2 | 8/11/19 11:28A | | | Example Analysis |

OIG FORM III – 234/1 (04/23/07)

EFTA00128338

CHAIN OF CUSTODY LOG CDFRM

BP-A0971

AUG_11

FEDERAL BUREAU OF PRISONS

AUG 11

U.S. DEPARTMENT OF JUSTICE

ECN # NYM-19-0163



ITEM # NYM-19-00185



(Enclose with/attach to evidence)

SUSPECT (If known) N/A

CASE ID NUMBER:

num. 1 Computer # 0214207268

DESCRIPTION OF ITEM: ___

08/11/19 11:00 A.M

LOCATION:___

SIGNATURE OF PERSON RECOVERING EVIDENCE:___

PRINTED NAME:___

EVIDENCE PLACED IN OVERNIGHT DROP BOX:

DROP-BOX BY:(printed name)___

Date & Time:___

Witness: (printed name)___

EVIDENCE RECOVERED FROM OVERNIGHT DROP BOX BY:

(printed name)___

Date & Time:___

Witness: (printed name)___

EVIDENCE PLACED EVIDENCE SAFE BY:

(printed name)___

Date & Time: ___

Witness: (printed name)___

DISPOSITION:

( ) Hold as evidence

( ) Return to owner

( ) Lab Analysis



( ) Return to finder



( ) Destroy immediately



(✓) Other



[ ] FBI

REMARKS (condition of evidence):

CHAIN OF CUSTODY

CHAIN OF CUSTODY

<table border="1"><tr><td>EVIDENCE RELEASED BY:</td><td>DATE/TIME:</td><td>DESTINATION:</td><td>EVIDENCE RELEASED TO:</td></tr><tr><td></td><td>08-11-19</td><td>OIG</td><td></td></tr><tr><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td></td></tr></table>



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