EFTA00132067



FD-1004
Rev. 10-13-2020


EVIDENCE CHAIN OF CUSTODY

<table><thead><tr><th>Relinquished Custody</th><th>Date and Time</th><th>Accepted Custody</th><th>Date and Time</th></tr></thead><tbody><tr><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td><td>Signature:<br>Printed Name:</td><td>9105720</td></tr><tr><td>Reason:</td><td>Reason: 501.4 from E6526227</td><td>1302</td></tr><tr><td>Relinquished Custody</td><td>Date and Time</td><td>Accepted Custody</td><td>Date and Time</td></tr><tr><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td><td>Signature:<br>Printed Name:</td><td>9105720</td></tr><tr><td>Reason:</td><td>Reason: 510.65e</td><td>1302</td></tr><tr><td>Relinquished Custody</td><td>Date and Time</td><td>Accepted Custody</td><td>Date and Time</td></tr><tr><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2">9105720<br>11:50</td><td>Signature:<br>Printed Name/Agency:</td><td>9105720</td></tr><tr><td>Reason:</td><td>Reason:</td><td>11:50</td></tr><tr><td>Relinquished Custody</td><td>Date and Time</td><td>Accepted Custody</td><td>Date and Time</td></tr><tr><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td></tr><tr><td>Reason:</td><td>Reason:</td></tr><tr><td>Relinquished Custody</td><td>Date and Time</td><td>Accepted Custody</td><td>Date and Time</td></tr><tr><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td></tr><tr><td>Reason:</td><td>Reason:</td></tr><tr><td>Relinquished Custody</td><td>Date and Time</td><td>Accepted Custody</td><td>Date and Time</td></tr><tr><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td></tr><tr><td>Reason:</td><td>Reason:</td></tr><tr><td>Relinquished Custody</td><td>Date and Time</td><td>Accepted Custody</td><td>Date and Time</td></tr><tr><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td></tr><tr><td>Reason:</td><td>Reason:</td></tr><tr><td>Relinquished Custody</td><td>Date and Time</td><td>Accepted Custody</td><td>Date and Time</td></tr><tr><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td></tr><tr><td>Reason:</td><td>Reason:</td></tr><tr><td>Relinquished Custody</td><td>Date and Time</td><td>Accepted Custody</td><td>Date and Time</td></tr><tr><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td><td>Signature:<br>Printed Name/Agency:</td><td rowspan="2"></td></tr><tr><td>Reason:</td><td>Reason:</td></tr></tbody></table>

Case ID: 90A-M-315227 IB: 52 Barcode: E6773798

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