EFTA00132057¶
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 Recommendation¶
Signature: Printed N: Reason: Collected Agency:¶
Date and Time¶
Accepted Custody¶
Signature: Printed N: Reason¶
This form is incomplete without reference to the FD-1087.¶
EFTA00132058¶
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 Seizure Printed Name/Agency Reason: Initial Custody Collector: By: Agency:¶
Date and Time 8/14/19 11:30 PM¶
Relinquished Custody¶
Date and Time 8/16-19 5:47 PM¶
Accepted Custody¶
Date and Time 8/14/19 5:47 PM¶
Relinquished Custody¶
Date and Time 8/20/19 3:00 PM¶
Accepted Custody¶
Date and Time 8/20/19 3:00 PM¶
Relinquished Custody¶
Date and Time 5/20/22 11:50 PM¶
Accepted Custody¶
Date and Time 5/3/22 11:50 PM¶
Accepted Custody¶
Date and Time 5/3/22 11:50 PM¶
Relinquished Custody¶
Date and Time 5/3/22 11:50 PM¶
Accepted Custody¶
Date and Time 5/3/22 11:50 PM¶
Firearm Certification by (FI/SWAT) / Explosive Material Certification by (SABT):¶
Printed Name:¶
Signature:¶
Date:¶
Barcode: E6S15232¶
This form is incomplete without reference to the FD-1087.¶
EFTA00132059¶
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 ___
Relinquished Custody¶
| Date and Time | Accepted Custody | Date and Time |
|---|---|---|
| Signature: | Signature: | Signature: |
| Printed Name: | Printed Name: | Printed Name: |
| Reason: | Reason: | Reason: |
Relinquished Custody¶
| Date and Time | Accepted Custody | Date and Time |
|---|---|---|
| Signature: | Signature: | Signature: |
| Printed Name: | Printed Name: | Printed Name: |
| Reason: | Reason: | Reason: |
Relinquished Custody¶
| Date and Time | Accepted Custody | Date and Time |
|---|---|---|
| Signature: | Signature: | Signature: |
| Printed Name: | Printed Name: | Printed Name: |
| Reason: | Reason: | Reason: |
Relinquished Custody¶
| Date and Time | Accepted Custody | Date and Time |
|---|---|---|
| Signature: | Signature: | Signature: |
| Printed Name: | Printed Name: | Printed Name: |
| Reason: | Reason: | Reason: |
Firearm Certification by (FI/SWAT) / Explosive Material Certification by (SABT):¶
Printed Name: Signature:¶
Case ID: 90A-NY-3151227¶
1B: 42¶
This form is incomplete without reference to the FD-1087.¶