EFTA00129463¶
FD-515 (Rev. 12-19-06)¶
Squad supervisor approval¶
(please initial)¶
Date Prepared 12/15/09¶
(Accomplishment must be reported and loaded into ISRAA within 30 days from date of accomplishment)¶
Investigative Assistance or Technique Used¶
- Used, but did not help
- Helped, minimally
- Absolutely essential
- Sub Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO
A. Complaint / Information / Indictment¶
- Federal / Local / International
- Complaint Date: Check if Civil Rico Complaint
- Information Date: Indictment Date
B. Locate / Arrest¶
- Federal / Local / International
- Subject Priority: A B C
- Locate Date: 12/08/09
- Arrest Date: Subject Resisted Arrest
- Subject Arrested was Armed
C. Summons Date¶
- Federal / Local
D. Recovery / Restitution / PELP X¶
- Federal / Local / International
- Recovery Date: Code ✓ Amount $
- Code✓ Amount $
- Restitution Date: Court Ordered ✓ Pretrial Diversion
- Code✓ Amount $
- PELP Date: Code✓ Amount $
E. Hostages(s) Released Date:¶
- Released by □ Territorial □ Other
- Number of Hostages: ✓
P. Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks E, I, L and N¶
F. Conviction¶
- Federal / Local / International
- Conviction Date: Subject Description Code • (•)
- For 6F, G, H-Include Agency Code
- Feiony or Misdemeanor
- Plea or Trial
- State: Judicial District:
G. U.S. Code Violation¶
- Required for sections A, B, F and J (Federal Only)
H. Sentence Date:¶
- Sentence Type:
- In Jail
- Suspended
- Years Months
- Probation: Years Months
- Fines: $
I. Disruption/Dismantlement:¶
- Disruption Date:
- Dismantlement Date:
- Completion of FD-515a Side 2 Mandatory
J. Civil Rico Matters Date:¶
- Also complete “Section G”
- Other Civil Matters Date:
- Judgment
- Judicial Outcome
- x
- Amount $
- Suspension: Years Months
K. Administrative Sanction Date:¶
- Subject Description Code •
- Type:
- Suspension
- Permanent
- Debsement
- Year Months
L. Asset Seizure Date:¶
- Asset Forfeiture Date:
- CATR’s Mandatory
- Circle before one of the three asset foreclosure:
- Admin, Civil Judicial, or Criminal
- Do not indicate $ value in Section D
M. Acquittal / Dismissal / Pretrial Diversion (Circle one) Date:¶
N. Drug Seizures ✓ Date:¶
- Drug Code✓ Weight✓ Code✓ PDN
- Do not indicate $ in Section D
O. Child Victim Information¶
Child located / Identified Date:¶
- Living
- Deceased
P. Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks E, I, L and N¶
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Additional information may be added by attaching another form or a plain sheet of paper for additional entries.
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See codes on reverse side.
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See codes on reverse side.
√ Requires that an explanation be attached and loaded into ISRAA for recovery over $1 m and PELP over $5 m, disruption, dismantlement, and drug seizure.¶
72-MM-113327-17¶
EFTA00129464¶