Police record

Blank FBI evidence chain of custody form (FD-1004)

An unfilled FBI FD-1004 evidence chain of custody form with blank signature and custody fields.Machine-written summary

EFTA00132043¶

FD-1004 Rev. 10-13-2020¶

EVIDENCE CHAIN OF CUSTODY¶

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:
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: ___ 1B: ___ Barcode: ___¶

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

Also released as

The same pages were released more than once, under different numbers.