EFTA00132019



FD-1004
Rev. 7-7-2016


FEDERAL BUREAU OF INVESTIGATION
EVIDENCE CHAIN OF CUSTODY

Evidence Type: □ General □ Drugs □ Firearms/Weapon □ Digital □ Valuables □ Firearms/Other Item # 13

Special Handling Instructions

□ HAZMAT □ Latents □ FGJ
□ Req. Charging □ Freeze □ Refrigerate
□ Biohazard □ Other ___

Initial Receipt

Signature of Seizing Date and Time
Printed Name/Agency
Reason: Initial Collection
Collected By Agency: FB

Date and Time

Relinquished Custody
Signature:
Printed Name:
Reason: TO CART

Date and Time
Accepted Custody
Signature:
Printed Name:
Reason: CAH

Date and Time
Relinquished Custody
Signature:
Printed Name:
Reason: TO CAH

Date and Time
Accepted Custody
Signature:
Printed N
Reason: CAH

Date and Time
Relinquished Custody
Signature:
Printed N
Reason: TO CAH

Date and Time
Accepted Custody
Signature:
Printed N
Reason: CAH

Date and Time
Accepted Custody
Signature:
Printed N
Reason: TO CAH

Date and Time
Accepted Custody
Signature:
Printed N
Reason: TO CAH

Date and Time
Accepted Custody
Signature:
Printed N
Reason: TO CAH

Date and Time
Accepted Custody
Signature:
Printed N
Reason: TO CAH

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

Printed Name:

Signature:

Date:

Case ID: 90A-NY-3151227

Barcode: E651 6206

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

EFTA00132020

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>25/02 10:03</td><td>Signature: Printed Name Reason:</td><td>9/25/20 22:02</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>9/25/20 11:50</td><td>Signature: Printed Name Reason:</td><td>3/30/20 11:50</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>5/30/20 11:50</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>

Case ID: 90A-NM-3151227 IB: 13 Barcode: €651.6206

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