EFTA00132034



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 Seller:
Printed Name/Area:
Reason: Initial
Collected By: Agency: FB1

Date and Time

8/10/19 4:30pm

Relinquished Custody

Date and Time
8/12/19 10:00 AM
Reason: To CAST

Accepted Custody

8/12/19 10:00 AM
Reason: TO CAST

Relinquished Custody

Date and Time
8/15/19 10:20 AM
Reason: TO CAST

Accepted Custody

8/15/19 10:20 AM
Reason: TO CAST

Relinquished Custody

Date and Time
8/15/19 2:00 PM
Reason: TO CAST

Accepted Custody

8/15/19 2:00 PM
Reason: TO CAST

Relinquished Custody

Date and Time
8/15/19 2:00 PM
Reason: TO CAST

Accepted Custody

8/15/19 2:00 PM
Reason: TO CAST

Relinquished Custody

Date and Time
8/15/19 2:00 PM
Reason: TO CAST

Accepted Custody

8/15/19 2:00 PM
Reason: TO CAST

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

Printed Name:

Signature:

Date:

Barcode: E6516211

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

EFTA00132035

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:</td><td>9/25/20</td><td>Signature:</td><td>9/25/20</td></tr><tr><td>Printed Name:</td><td>12:01</td><td>Printed Name:</td><td>12:02</td></tr><tr><td>Reason:</td><td colspan="3">Reason: Service</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:</td><td>5/24/20</td><td>Signature:</td><td>5/24/20</td></tr><tr><td>Printed Name/A:</td><td>11:54</td><td>Printed Name:</td><td>11:54</td></tr><tr><td>Reason:</td><td colspan="3">Reason: Change out</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:</td><td>5/3/20</td><td>Signature:</td><td>5/3/20</td></tr><tr><td>Printed Name/A:</td><td>11:54</td><td>Printed Name/Agency:</td><td></td></tr><tr><td>Reason:</td><td colspan="3">Reason:</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:</td><td></td><td>Signature:</td><td></td></tr><tr><td>Printed Name/Agency:</td><td></td><td>Printed Name/Agency:</td><td></td></tr><tr><td>Reason:</td><td colspan="3">Reason:</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:</td><td></td><td>Signature:</td><td></td></tr><tr><td>Printed Name/Agency:</td><td></td><td>Printed Name/Agency:</td><td></td></tr><tr><td>Reason:</td><td colspan="3">Reason:</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:</td><td></td><td>Signature:</td><td></td></tr><tr><td>Printed Name/Agency:</td><td></td><td>Printed Name/Agency:</td><td></td></tr><tr><td>Reason:</td><td colspan="3">Reason:</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:</td><td></td><td>Signature:</td><td></td></tr><tr><td>Printed Name/Agency:</td><td></td><td>Printed Name/Agency:</td><td></td></tr><tr><td>Reason:</td><td colspan="3">Reason:</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:</td><td></td><td>Signature:</td><td></td></tr><tr><td>Printed Name/Agency:</td><td></td><td>Printed Name/Agency:</td><td></td></tr><tr><td>Reason:</td><td colspan="3">Reason:</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:</td><td></td><td>Signature:</td><td></td></tr><tr><td>Printed Name/Agency:</td><td></td><td>Printed Name/Agency:</td><td></td></tr><tr><td>Reason:</td><td colspan="3">Reason:</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:</td><td></td><td>Signature:</td><td></td></tr><tr><td>Printed Name/Agency:</td><td></td><td>Printed Name/Agency:</td><td></td></tr><tr><td>Reason:</td><td colspan="3">Reason:</td></tr></tbody></table>

Case ID: 70A-M-3151227 IB: 18 Barcode: E6S16212

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