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:¶
(Communication Enclosing Material)¶
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¶