EFTA00132028¶
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¶
☐ HAZMAT ☐ Latents ☐ FGJ ☐ Req. Charging ☐ Freeze ☐ Refrigerate ☐ Biohazard ☐ Other ___¶
Initial Receipt¶
Signature of Sender: Printed Name/Agency: Reason: Collected By: Agency: FB¶
Date and Time¶
Date and Time¶
Date and Time¶
Date and Time¶
Date and Time¶
Date and Time¶
Date and Time¶
Date and Time¶
Firearm Certification by (FI/SWAT) / Explosive Material Certification by (SABT):¶
Printed Name:¶
Signature:¶
Date:¶
Case ID: 90A-NY-3151227¶
Barcode: 66516209¶
This form is incomplete without reference to the FD-1087.¶
EFTA00132029¶
EVIDENCE CHAIN OF CUSTODY¶
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
|---|---|---|---|
| Signature: | 5/12/20 11:00am | Signature: | |
| Printed Name | Printed Name | ||
| Reason: | Reason: | ||
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| Signature: | 5/12/20 11:00am | Signature: | |
| Printed Name | 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: | ||
| 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: | ||
| 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: |
Case ID: 90A-M-3151227 IB: 16 Barcode: E6S16209¶
This form is incomplete without reference to the FD-1087.¶