FBI evidence chain of custody forms, August 2019

EFTA00132041¶

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 Seizing Person: Printed Name/Agency:
• Reason: Initial Collection
• Collected By:
• Agency: FBI

Reliquished Custody¶

• Date and Time: 8/16/19 2:20pm
• Accepted Custody: Signature: Printed Name Reason: Charge to OTD

Reliquished Custody¶

• Date and Time: 8/16/19 4:30pm
• Accepted Custody: Signature: Printed Name Reason: Transport to OTD

Reliquished Custody¶

• Date and Time: 8/17/19 12:30pm
• Accepted Custody: Signature: Printed Name Reason: Received from CRF

Reliquished Custody¶

• Date and Time: 8/17/19 12:30pm
• Accepted Custody: Signature: Printed Name Reason: Received from CRF

Reliquished Custody¶

• Date and Time: 5/2/22 11:50pm
• Accepted Custody: Signature: Printed Name Reason: Change out

Reliquished Custody¶

• Date and Time: 6/3/20 11:50pm
• Accepted Custody: Signature: Printed Name/Agency Reason:

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

ATF Trace Form Completed: □ NCIC: □¶

Firearm Certification by(FI/SWAT)/Explosive Material Certification by(SABT):	ATF Trace Form Completed:□NCIC:□
Printed Name:
Signature:
Date:

Case ID: 90A-NY-3151227¶

IB: 23¶

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

EFTA00132042¶

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 Instructions			Initial Receipt	Date and Time 8/12/19 7:00pm
□ HAZMAT □ Latents □ FGJ □ Req. Charging □ Freeze □ Refrigerate □ Biohazard □ Other ___			Signature of Seizing Indent Printed Name: Reason: Initial Collection
			Collected By: Agency: FBL
Relinquished		Date and Time	Accepted Custody
Signature:		8/16/19	Signature:
Printed N		2:00 pm	Printed N	Reason: Charged In Office
Reason:			Reason:
Relinquished		Date and Time	Accepted Custody	Date and Time 8/16/19 4:30 pm
Signature:		8/16/19	Signature:
Printed N		14:30 pm	Printed N	Reason:
Reason:			Reason:
Relinquished		Date and Time	Accepted Custody	Date and Time 8/17/19 12:30 pm
Signature:		8/19/19	Signature:
Printed N		12:30 pm	Printed N	Reason: Paid for USTD
Reason:			Reason:
Relinquished Custody		Date and Time	Accepted Custody	Date and Time 9/25/20 3:20 am
Signature:		8/20/19	Signature:
Printed N		4:50 pm	Printed N	Reason: Received from CFF
Reason:			Reason:
Relinquished Custody		Date and Time	Accepted Custody	Date and Time 5/24/20 11:00 am
Signature:		5/24/20	Signature:
Printed N		11:00 pm	Printed N	Reason: Change act
Reason:			Reason:
Relinquished Custody		Date and Time	Accepted Custody	Date and Time
Signature:		5/23/20	Signature:
Printed N		11:00 pm	Printed Name/Agency:
Reason:			Reason:

Firearm Certification by(FI/SWAT)/Explosive Material Certification by(SABT):	ATF Trace Form Completed:□NCIC:□
Printed Name:
Signature:
Date:

IB: 24¶

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