EFTA00132067¶
FD-1004 Rev. 10-13-2020¶
EVIDENCE CHAIN OF CUSTODY¶
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
|---|---|---|---|
| Signature: Printed Name/Agency: | Signature: Printed Name: | 9105720 | |
| Reason: | Reason: 501.4 from E6526227 | 1302 | |
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| Signature: Printed Name/Agency: | Signature: Printed Name: | 9105720 | |
| Reason: | Reason: 510.65e | 1302 | |
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| Signature: Printed Name/Agency: | 9105720 11:50 | Signature: Printed Name/Agency: | 9105720 |
| Reason: | Reason: | 11:50 | |
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| Signature: Printed Name/Agency: | Signature: Printed Name/Agency: | ||
| Reason: | Reason: | ||
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| Signature: Printed Name/Agency: | Signature: Printed Name/Agency: | ||
| Reason: | Reason: | ||
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| Signature: Printed Name/Agency: | Signature: Printed Name/Agency: | ||
| Reason: | Reason: | ||
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| Signature: Printed Name/Agency: | Signature: Printed Name/Agency: | ||
| Reason: | Reason: | ||
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| Signature: Printed Name/Agency: | Signature: Printed Name/Agency: | ||
| Reason: | Reason: | ||
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time |
| Signature: Printed Name/Agency: | Signature: Printed Name/Agency: | ||
| Reason: | Reason: |
Case ID: 90A-M-315227 IB: 52 Barcode: E6773798¶
This form is incomplete without reference to the FD-1087.¶