EFTA00131984



FD-1004
Rev. 7-7-2016


FEDERAL BUREAU OF INVESTIGATION
EVIDENCE CHAIN OF CUSTODY

## Evidence Type:
- General
- Drugs
- Firearms/Waapon
- Digital
- Valuables
- Firearms/Other

## Special Handling Instructions

| Special Handling Instructions | Initial Receipt | Date and Time |
| :--- | :--- | :--- |
| □ HAZMAT □ Latents □ FGJ | Signature of Seizing Invoice | 8/10/19 |
| □ Req. Charging □ Freeze □ Refrigerate | Printed Name/Agency: | |
| □ Biohazard | Reason: Initial Collection | 4:30pm |
| □ Other | Collected By: Agency: FBI | |

## Relinquished Custody

| Date and Time | Accepted Custody | Date and Time |
| :--- | :--- | :--- |
| Signature: | Signature: | 8/12/19 |
| Printed Name: | Printed Name: | 10:00am |
| Reason: TO CART | Reason: | |

## Relinquished Custody

| Date and Time | Accepted Custody | Date and Time |
| :--- | :--- | :--- |
| Signature: | Signature: | 8/15/19 |
| Printed Name/Agency: | Printed Name/Agency: | 10:20am |
| Reason: TO GIA | Reason: RECEIVED | |

## Relinquished Custody

| Date and Time | Accepted Custody | Date and Time |
| :--- | :--- | :--- |
| Signature: | Signature: | 8/15/19 |
| Printed Name/Agency: | Printed Name/Agency: | 2:00pm |
| Reason: TRANSFER | Reason: ACCEPTED | |

## Relinquished Custody

| Date and Time | Accepted Custody | Date and Time |
| :--- | :--- | :--- |
| Signature: | Signature: | 8/16/19 |
| Printed Name/Agency: | Printed Name/Agency: | 3:00pm |
| Reason: TRANSPORT TO OTD | Reason: RECEIVED FROM ERF | 9/25/20 11:00 |

## Relinquished Custody

| Date and Time | Accepted Custody | Date and Time |
| :--- | :--- | :--- |
| Signature: | Signature: | |
| Printed Name/Agency: | Printed Name/Agency: | |
| Reason: | Reason: |

## Firearm Certification by (FI/SWAT) / Explosive Material Certification by (SABT):

| Signature: | Signature: |
| :--- | :--- |

ATF Trace Form Completed:

NCIC: □

Case ID: 90A-NY-3151227

This form is incomplete without reference to the FD-1087.

EFTA00131985

EVIDENCE CHAIN OF CUSTODY

<table><thead><tr><th>Reliquished Custody</th><th>Date and Time</th><th>Accepted</th><th></th><th>Date and Time</th></tr></thead><tbody><tr><td>Signature:<br>Printed Name/Agency:<br>Reason:</td><td>5/10/20<br>11:50am</td><td>Signature:<br>Printed Name/Agency:<br>Reason:</td><td></td><td>5/10/20<br>11:50am</td></tr><tr><td>Reliquished Custody</td><td>Date and Time</td><td>Accepted Custody</td><td></td><td>Date and Time</td></tr><tr><td>Signature:<br>Printed Name/Agency:<br>Reason:</td><td>5/13/20<br>11:50am</td><td>Signature:<br>Printed Name/Agency:<br>Reason:</td><td></td><td></td></tr><tr><td>Reliquished Custody</td><td>Date and Time</td><td>Accepted Custody</td><td></td><td>Date and Time</td></tr><tr><td>Signature:<br>Printed Name/Agency:<br>Reason:</td><td>

Case ID: 90A-NY-3151227 1B: 1 Barcode: E6S16I94

This form is incomplete without reference to the FD-1087.