EFTA00129655





FD-340 (Rev. 4-11-03)

File Number 72-MM-113327-A4

Field Office Acquiring Evidence ___

Serial # of Originating Document ___

Date Received 11/3

(Name of Contributor/Interviewee)

[Address]

By SA

To Be Returned □ Yes □ No

Receipt Given □ Yes □ No

Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e)



□ Yes □ No



Federal Taxpayer Information (FTI)

☐ Yes ☐ No

Title:

Reference:

<font color="red">(Communication Enclosing Material)</font>

Description: Original notes re interview or

$\textcircled{1}$FD-26 Consent to Search signed

Alfredo Rodriguez

$\textcircled{2}$FD-39.5 signed Alfredo Rodriguez



只