EFTA00132046 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 □ FGJ
□ Req. Charging □ Freeze □ Refrigerate
□ Biohazard
□ Other ___		Signature of
Printed Name
Reason: Initial
Collected By
Agency: FBI		8/12/19
7:00pm
Relinquished CustodyDate and TimeAccepted CustodyDate and Time
8/16/19Signature:8/26/19
3:15pmPrinted N3:15pm
Reason: Charged In Storage4:30pm
Date and TimeAccepted CustodyDate and Time
Relinquished CustodyDate and TimeAccepted CustodyDate and Time
8/16/19Signature:8/14/19
4:30pmPrinted N4:30pm
Reason: CHAT12:09pm
Date and TimeAccepted CustodyDate and Time
Relinquished CustodyDate and TimeAccepted CustodyDate and Time
8/19/19Signature:8/19/19
12:30pmPrinted N12:30pm
Reason: Transfer TO OTD
Date and TimeAccepted CustodyDate and Time
Relinquished CustodyDate and TimeAccepted CustodyDate and Time
8/19/19Signature:8/19/19
12:30pmPrinted N12:30pm
Reason: Received From CFH
Date and TimeAccepted CustodyDate and Time
Relinquished CustodyDate and TimeAccepted CustodyDate and Time
8/19/19Signature:8/19/19
12:30pmPrinted N12:30pm
Reason: Change out
Date and TimeAccepted CustodyDate and Time
Firearm Certification by (FI/SWAT) / Explosive Material Certification by (SABT):
Printed Name:
Firearm Certification by(FI/SWAT)/Explosive Material Certification by(SABT):ATF Trace Form Completed:□NCIC:□
Printed Name:
Signature:
Date:
IB: 26 This form is incomplete without reference to the FD-1087. EFTA00132047 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** - ☐ HAZMAT □ Latents □ FGJ - ☐ Req. Charging □ Freeze □ Refrigerate - ☐ Biohazard - ☐ Other **Initial Receipt** - Signature of Seller: - Printed Name/ - Reason: initial - Collected By: - Agency: FBI **Date and Time** - Date and Time: 8/10/19 - Date and Time: 3:15pm - Date and Time: 8/16/19 - Date and Time: 4:30pm **Reliquition** - Signature: - Printed Name: - Reason: TO EVIDENCE **Date and Time** - Date and Time: 8/10/19 - Date and Time: 4:30pm - Date and Time: 8/16/19 - Date and Time: 4:30pm **Reliquition** - Signature: - Printed Name: - Reason: TRANSFER **Date and Time** - Date and Time: 8/17/19 - Date and Time: 12:30pm - Date and Time: 8/20/19 - Date and Time: 850am **Reliquition** - Signature: - Printed Name: - Reason: Release NOT FOR EFM **Date and Time** - Date and Time: 8/20/19 - Date and Time: 11:30m - Date and Time: 9/300 - Date and Time: 11:50am **Reliquition** - Signature: - Printed Name: - Reason: Charge at transfer to W1/07/16 **Accepted Custody** - Date and Time: Accepted Custody - Signature: - Printed Name: - Reason: Charge to OTP **Accepted Custody** - Date and Time: Accepted Custody - Signature: - Printed Name: - Reason: Received from ERF **Accepted Custody** - Date and Time: Accepted Custody - Signature: - Printed Name: - Reason: Charge out **Accepted Custody** - Date and Time: Accepted Custody - Signature: - Printed Name: - Reason: Charge out **Firearm Certification by (FI/SWAT) / Explosive Material Certification by (SABT):** ATF Trace Form Completed: □
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: 27 Barcode: E6515205 This form is incomplete without reference to the FD-1087. EFTA00132048 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 | | Initial Receipt | | :--- | :--- | | □ HAZMAT □ Latents □ FGJ | Signature of Seizing I | | □ Req Charging □ Freeze □ Refrigerate | Printed Name/Agency | | □ Biohazard | Reason: Initial Collection | | □ Other | Collected By: Agency: FBI | ## Relinquited | Date and Time | Accepted Custody | | :--- | :--- | | Signature: 4/16/19 | Signature: | | Printed N: 3:50pm | Printed N: | | Reason: Charged to Storage | Reason: Charged to Storage | | Date and Time | Accepted Custody | | :--- | :--- | | Signature: 8/16/19 | Signature: | | Printed N: 11:30pm | Printed N: | | Reason: CART | Reason: CART | | Date and Time | Accepted Custody | | :--- | :--- | | Signature: 8/10/19 | Signature: | | Printed N: 14:30pm | Printed N: | | Reason: Transport | Reason: Transport | ## Relinquished Custody | Date and Time | Accepted Custody | | :--- | :--- | | Signature: 8/10/19 | Signature: | | Printed N: 12:30pm | Printed N: | | Reason: Received from ERF | Reason: Received from ERF | ## Relinquished Custody | Date and Time | Accepted Custody | | :--- | :--- | | Signature: 8/16/19 | Signature: | | Printed N: 8:50pm | Printed N: | | Reason: Received from ERF | Reason: Received from ERF | ## Relinquished Custody | Date and Time | Accepted Custody | | :--- | :--- | | Signature: 8/10/19 | Signature: | | Printed N: 11:50pm | Printed N: | | Reason: Received from ERF | Reason: Received from ERF | ## Firearm Certification by (FI/SWAT) / Explosive Material Certification by (SABT): | Signature: | | :--- | | Printed Name: | | Signature: | ATF Trace Form Completed: NCIC: □
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.