EFTA00132044¶
FD-1004 Rev. 7-7-2016¶
FEDERAL BUREAU OF INVESTIGATION EVIDENCE CHAIN OF CUSTODY¶
| Evidence Type: □ General □ Drugs □ Firearms/Weapon □ Digital □ Valuables □ Firearms/Othe: Item # ___ | |||
|---|---|---|---|
| Special Handling Instructions | Initial Receipt | Date and Time | |
| ☐ HAZMAT ☐ Latents ☐ FGJ ☐ Resq Charging ☐ Freeze ☐ Refrigerate ☐ Biohazard ☐ Other ___ | Signature of Seizing Inc. Printed Name/Agency: Reason: Initial Collection Collected By: Agency: FBI | 8/10/197:00pm | |
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| 8/16/192:00pm | Signature: Printed N Reason: Changed Storage | 8/26/192:20pm | |
| 8/16/1914:30pm | Signature: Printed N Reason: CHART | 8/16/194:30pm | |
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| 8/19/1912:30pm | Signature: Printed N Reason: Transport to OTD | 8/19/1912:30pm | |
| 8/20/19850m | Signature: Printed N Reason: Received from ERF | 9/15/2011:50am | |
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| 7/16/2011:50m | Signature: Printed N Reason: Change out | 9/20/2011:50am | |
| 5/202111:50m | Signature: 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-3151827¶
IB: 25¶
Barcode: E6515203¶
This form is incomplete without reference to the FD-1087.¶