EFTA00132039 FD-1004 Rev. 7-7-2016 FEDERAL BUREAU OF INVESTIGATION EVIDENCE CHAIN OF CUSTODY
Evidence Type:GeneralDrugsFirearms/Weapon
DigitalValuablesFirearms/OtherItem # 2
Special Handling InstructionsInitial ReceiptDate and Time
HAZMAT Latents FGJ
Req. Charging Freeze Refrigerate
Biohazard
Other
Signature:9/15/19
4:45pm
Printed Name
Reason:
Collected Agency:
Relinquired Signature Printed ReasonDate and TimeAccepted CustodyDate and Time
8/15/19 6:00pmSignature:
Printed Name:
Reason:
8/15/19 6:00pm
8/14/19 12:00amSignature:
Printed Name:
Reason: receive transferred
8/14/21 10:44am
Relinquished Signature Printed ReasonDate and TimeAccepted CustodyDate and Time
10/14/21 11:30amSignature:
Printed Name:
Reason: from Split
10/14/21 11:30am
10/10/21 3:30pmSignature:
Printed Name/Agency:
Reason:
Relinquished Signature Printed ReasonDate and TimeAccepted CustodyDate and Time
5/2/20 11:50amSignature:
Printed Reason: charge out
5/2/20 11:50am
5/3/20 11:50amSignature:
Printed Name/Agency:
Reason:
Relinquished Signature Printed ReasonDate and TimeAccepted CustodyDate and Time
5/3/20 11:50amSignature:
Printed Name/Agency:
Reason:
5/3/20 11:50amSignature:
Printed Name/Agency:
Reason:
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: E6516213 This form is incomplete without reference to the FD-1087. EFTA00132040 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 #
Special Handling InstructionsInitial ReceiptDate and Time
HAZMAT Latents FGJReq Charging Freeze RefrigerateBiohazardOtherSignature of SignedPrinted NameReason: InitialCollected ByAgency: FBI8/12/197:00pm
Relinquished SignaturePrimeReason:Date and TimeAccepted CustodyDate and Time8/16/192:20pm
Relinquished SignaturePrinted NameReason:Date and TimeAccepted CustodyDate and Time8/16/194:30pm
Relinquited SignaturePrinted NameReason:Date and TimeAccepted CustodyDate and Time5/11/1912:30pm
Relinquished CustodySignaturePrinted NameReason:Date and TimeAccepted CustodyFeb 24 2010 4262Date and Time9/25/2012:00pm
Relinquished CustodySignaturePrinted NameReason:Date and TimeAccepted CustodySignaturePrinted Reason: Received from CRFDate and Time5/12/2011:50am
Relinquished CustodySignaturePrinted NameReason:Date and TimeAccepted CustodySignaturePrinted Reason: Change outDate and Time5/12/2011:50am
Relinquished CustodySignaturePrinted NameReason:Date and TimeAccepted CustodySignaturePrinted Reason:Date and Time
Firearm Certification by(FI/SWAT)/Explosive Material Certification by(SABT):ATF Trace Form Completed:□NCIC:□
Printed Name:
Signature:
Date:
This form is incomplete without reference to the FD-1087.