EFTA00132073 FD-1004 Rev.07-27-2021 EVIDENCE CHAIN OF CUSTODY
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Signature: Printed Name/Agency: Reason: | Date and Time | Signature: Printed Name: Reason: | 4/16/21 10:14am | |||||||||||||||||||||||||||||
| Relinquished Custody | Accepted Custody | Date and Time | ||||||||||||||||||||||||||||||
| Signature: Printed Name/Agency: Reason: | Date and Time | Signature: Printed Name: Reason: | 6/16/21 12:39pm | |||||||||||||||||||||||||||||
| Relinquished Custody | Accepted Custody | Date and Time | ||||||||||||||||||||||||||||||
| Signature: Printed Name/Agency: Reason: | 5/12/22 11:54am | Signature: Printed Name: Reason: | 5/12/22 11:00am | |||||||||||||||||||||||||||||
| Relinquished Custody | Date and Time | Accepted Custody | Date and Time | |||||||||||||||||||||||||||||
| Signature: Printed Name/Agency: Reason: | Date and Time | Signature: Printed Name/Agency: Reason: | ||||||||||||||||||||||||||||||
| Relinquished Custody | Accepted Custody
Case ID: 90A-NY-3151227 1B: 58 Barcode: E6944132
This form is incomplete without reference to the FD-1087.
EFTA00132074
FD-1004
Rev.07-27-2021
EVIDENCE CHAIN OF CUSTODY
|