EFTA00131992¶
FD-1004 Rev. 7-7-2016¶
FEDERAL BUREAU OF INVESTIGATION EVIDENCE CHAIN OF CUSTODY¶
| Evidence Type: | General | Drugs | Firearms/Wesipon | Item # |
|---|---|---|---|---|
| Digital | Valuables | Firearms/Other |
Special Handling Instructions¶
| Initial Receipt | Date and Time | |
|---|---|---|
| □ HAZMAT | Latents | Signature of Seizing Individual: |
| □ Req. Charging | Freeze | Printed Name/Agency: |
| □ Biohazard | Refrigerate | Reason: Initial Collection |
| □ Other | Collected By: Agency: FBI |
Relinquished Custody¶
| Date and Time | Accepted Custody | Date and Time |
|---|---|---|
| Signature: | 8/12/19 | Signature: 8/12/19 |
| Printed Name/Agency: | 10:20am | Printed Name/Agency: 10:20am |
| Reason: TO CART | Reason: | Reason: RECEIVEN |
Relinquished Custody¶
| Date and Time | Accepted Custody | Date and Time |
|---|---|---|
| Signature: | 8/15/15 | Signature: 8/15/15 |
| Printed Name/Agency: | 10:20am | Printed Name/Agency: 10:20am |
| Reason: TO CLA | Reason: RECEIVEN |
Relinquished Custody¶
| Date and Time | Accepted Custody | Date and Time |
|---|---|---|
| Signature: | 8/16/17 | Signature: 8/16/17 |
| Printed Name/Agency: | 2:00pm | Printed Name/Agency: 2:00pm |
| Reason: TRANSFER | Reason: ACCEPTED |
Relinquished Custody¶
| Date and Time | Accepted Custody | Date and Time |
|---|---|---|
| Signature: | 8/17/14 | Signature: 9/12/19 |
| Printed Name/Agency: | 3:10pm | Printed Name/Agency: 3:10pm |
| Reason: Transfer to OTD | Reason: RECEIVEN |
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: | Printed Name/Agency: | |
| Reason: | Reason: |
Firearm Certification by (FI/SWAT) / Explosive Material Certification by (SABT):¶
- Printed Name:
- Signature:
- Date:
This form is incomplete without reference to the FD-1087.¶
EFTA00131993¶
EVIDENCE CHAIN OF CUSTODY¶
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
|---|---|---|---|
| Signature: Printed Name/Agency: Reason: | 5/21/20 11:00am | Signature: Printed Name: Reason: | 5/31/20 11:00am |
| Relinquished Custody: | Date and Time | Accepted Custody | Date and Time |
| Signature: Printed Name/Agency: Reason: | 5/31/20 11:00am | Signature: Printed Name/Agency: Reason: | |
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| Signature: Printed Name/Agency: Reason: | Date and Time | Signature: Printed Name/Agency: Reason: | |
| Relinquished Custody | Accepted Custody
Case ID: 90A-M-3151227 IB: 4 Barcode: E6516297¶ This form is incomplete without reference to the FD-1087.¶ |