EFTA00132016



FD-1004
Rev. 7-7-2016


FEDERAL BUREAU OF INVESTIGATION
EVIDENCE CHAIN OF CUSTODY

# Evidence Type: □ General □ Drugs □ Firearms/Weapon □ Digital □ Valuables □ Firearms/Other

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

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

**Relinquished Custody:**
Date and Time | Accepted Custody | Date and Time |
| :--- | :--- | :--- |
| Signature: 8/15/19 | Signature: 8/15/19 | |
| Printed N: 10:20am | Printed N: 10:20am | |
| Reason: TO CA | Reason: RECEIVED | 10:20am |

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

**Relinquished Custody:**
Date and Time | Accepted Custody | Date and Time |
| :--- | :--- | :--- |
| Signature: 8/15/19 | Signature: 8/15/19 | |
| Printed N: 2:00pm | Printed N: 2:00pm | |
| Reason: TRANSFER | Reason: RECEIVED | 2:00pm |

**Relinquished Custody:**
Date and Time | Accepted Custody | Date and Time |
| :--- | :--- | :--- |
| Signature: 8/15/19 | Signature: 8/15/19 | |
| Printed N: 2:00pm | Printed N: 2:00pm | |
| Reason: TRANSFER | Reason: RECEIVED | 2:00pm |

**Firearm Certification by (FI/SWAT) / Explosive Material Certification by (SABT):**
ATF Trace Form Completed: □ NCIC: □

Printed Name:
Signature:
Date:

Case ID: 90A-NY-3151227

Barcode: 6516205

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

EFTA00132017

EVIDENCE CHAIN OF CUSTODY

<table><thead><tr><th>Relinquished Custody</th><th>Date and Time</th><th>Accepted Custody</th><th>Date and Time</th></tr></thead><tbody><tr><td>Signature: Printed Name Reason:</td><td>5/20/14 11:50am</td><td>Signature: Printed Name Reason:</td><td>5/20/14 11:50am</td></tr><tr><td>Relinquished Custody</td><td>Date and Time</td><td>Accepted Custody</td><td>Date and Time</td></tr><tr><td>Signature: Printed Name Reason:</td><td>5/20/14 11:50am</td><td>Signature: Printed Name/Agency: Reason:</td><td></td></tr><tr><td>Relinquished Custody</td><td>Date and Time</td><td>Accepted Custody</td><td>Date and Time</td></tr><tr><td>Signature: Printed Name/Agency: Reason:</td><td rowspan="2">Date and Time</td><td>Signature: Printed Name/Agency: Reason:</td><td rowspan="2"></td></tr><tr><td>Relinquished Custody</td><td>Accepted Custody

Case ID: 90A-M-3151227 IB: 12 Barcode: €6526205

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