FBI evidence chain of custody forms for case 90A-NY-3151227

EFTA00132060¶

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
Signature: 8/21/19	Signature: 8/22/19
Printed Name: 12:04pm	Printed Name: 12:04pm
Reason: To EVIDENCE	Reason: Cheddar In Storage
Date and Time	Accepted Custody
Signature: 5/9/27	Signature: 5/9/27
Printed Name: 11:50am	Printed Name: 11:50am
Reason: Change 04	Reason: Change 04

Relinquished Custody¶

Date and Time	Accepted Custody
Signature: 5/3/23	Signature:
Printed Name/Agency:	Printed Name/Agency:
Reason:	Reason:

Relinquished Custody¶

Date and Time	Accepted Custody
Signature:	Signature:
Printed Name/Agency:	Printed Name/Agency:
Reason:	Reason:

Relinquished Custody¶

Date and Time	Accepted Custody
Signature:	Signature:
Printed Name/Agency:	Printed Name/Agency:
Reason:	Reason:

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

• Printed Name:
• Signature:
• Date:

Case ID: 90A-NY-3151227 1B: 43 Barcode: €6515258¶

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

EFTA00132061¶

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 # NY1023654¶

Special Handling Instructions¶

Initial Receipt	Date and Time
□ HAZMAT □ Latents □ FGJ □ Req. Charging □ Freeze □ Refrigerate □ Biohazard □ Other ___	Signature of Seizing Individual 8/08/15 Printed Name/Agency 5:00PM Reason: Initial Collection Collected By: Agency: PBI

Relinquished Custody¶

Date and Time	Accepted Custody	Date and Time
Signature: Printed Name/Agency: Reason: Submit to ECU	9/3/19 8:00AM Signature: Printed Name/Agency Reason: CAST	9/3/19 7:40AM Signature: Printed Name/Agency Reason: CAST

Relinquished Custody¶

Date and Time	Accepted Custody	Date and Time
Signature: Printed Reason: LOC to SA	12/6/29 10:25 Signature: Printed Reason: CAST	12/6/29 10:00 Signature: Printed Reason: CAST

Relinquished Custody¶

Date and Time	Accepted Custody	Date and Time
Signature: Printed Reason: LOC to CAST	12/6/19 10:04 Signature: Printed Reason: CAST	12/6/19 10:24 Signature: Printed Reason: CAST

Relinquished Custody¶

Date and Time	Accepted Custody	Date and Time
Signature: Printed Reason: TO EVIDENCE	10/11/19 Signature: Printed Reason: CAST	10/11/19 Signature: Printed Reason: CAST

Relinquished Custody¶

Date and Time	Accepted Custody	Date and Time
Signature: Printed Reason: Change Out	5/2/22 Signature: Printed Reason: CHANGE OUT	5/2/22 Signature: Printed Reason: CHANGE OUT

Relinquished Custody¶

Date and Time	Accepted Custody	Date and Time
Signature: Printed Reason: Transfer to DRIVER	5/3/20 Signature: Printed Reason: CHANGE OUT	Signature: Printed Reason: CHANGE OUT

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

• Printed Name:
• Signature:
• Date:

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