EFTA00131989 FD-1004 Rev. 7-7-2016 FEDERAL BUREAU OF INVESTIGATION EVIDENCE CHAIN OF CUSTODY
| Special Handling Instructions | Initial Receipt | Date and Time | ||
|---|---|---|---|---|
| □ HAZMAT □ Latents □ FGJ □ Req. Charging □ Freeze □ Refrigerate □ Biohazard □ Other ___ | Signature of Seizing Individual: | 8/10/19 4:30pm | ||
| Printed Name/Agency: | ||||
| Reason: Initial Collection | ||||
| Collected By: Agency: FBI | ||||
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time | |
| Signature: | 8/12/19 10:00am | Signature: | 8/12/19 10:00am | |
| Printed Name/Agency: | 10:00am | Printed Name/Agency: | 10:00am | |
| Reason: To Cart | Reason: CAST | |||
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time | |
| Signature: | 8/15/19 10:00am | Signature: | 8/15/19 10:00am | |
| Printed Name/Agency: | 10:00am | Printed Name/Agency: | 10:00am | |
| Reason: To CA | Reason: Accepted | |||
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time | |
| Signature: | 8/15/19 2:00am | Signature: | 8/15/19 2:00am | |
| Printed Name/Agency: | Printed Name/Agency: | |||
| Reason: Transfer to OTD | Reason: Accepted | |||
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time | |
| Signature: | Signature: | |||
| Printed Name/Agency: | Printed Name/Agency: | |||
| Reason: | Reason: | |||
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time | |
| Signature: | Signature: | |||
| Printed Name/Agency: | ||||
| Reason: | ||||
| Rollingquished Custody | Date and Time | Accepted Custody | Date and Time |
|---|---|---|---|
| Signature: Printed Name/Agency: Reason: | 5/26/02 11:58am | Signature: Printed Name/Agency: Reason: | 5/26/02 11:58am |
| Rollingquished Custody | Date and Time | Accepted Custody | Date and Time |
| Signature: Printed Name/Agency: Reason: | 5/30/02 11:59am | Signature: Printed Name/Agency: Reason: | |
| Rollingquished Custody | Date and Time | Accepted Custody | Date and Time |
| Signature: Printed Name/Agency: Reason: | Date and Time | Signature: Printed Name/Agency: Reason: | |
| Rollingquished Custody | Accepted Custody Case ID: 90A-WM-3IS1227 IB: 3 Barcode: E65I6I96 This form is incomplete without reference to the FD-1087. |