EFTA00132089



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 # 10 |

**Special Handling Instructions**

- □ HAZMAT
- □ Latents
- □ FGJ
- □ Req. Charging
- □ Freeze
- □ Refrigerate
- □ Biohazard
- □ Other

Agency: FBI

Date and Time
8/10/19 4:30 pm

Reason:

Date and Time
8/10/19 10:00 AM

Reason:

Date and Time
8/15/19 10:20 AM

Reason:

Date and Time
15/15 2:00 PM

Reason:

Accepted Custody
FED SA A 7276 2020 4468

Date and Time
12/31/20 22:00 PM

Reason: Received from ERF

Accepted Custody

Date and Time

Signature:
Printed Name/Agency:
Reason:

Accepted Custody

Signature:
Printed Name/Agency:
Reason:

Accepted Custody

Signature:
Printed Name/Agency:
Reason:

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

Printed Name:

Signature:

Date:

Case ID: 90A-NY-3151227

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

EFTA00132090

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 rowspan="3">Reason:</td><td rowspan="3">5/22/14 11:50am</td><td>Accepted Custody</td><td>Date and Time</td></tr><tr><td>Signature:</td><td rowspan="2"></td></tr><tr><td>Printed Name/Agency:</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:</td><td rowspan="3"></td><td>Signature:</td><td rowspan="3"></td></tr><tr><td>Printed Name/Agency:</td><td>Printed Name/Agency:</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:</td><td rowspan="3"></td><td>Signature:</td><td rowspan="3"></td></tr><tr><td>Printed Name/Agency:</td><td>Printed Name/Agency:</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:</td><td rowspan="3"></td><td>Signature:</td><td rowspan="3"></td></tr><tr><td>Printed Name/Agency:</td><td>Printed Name/Agency:</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:</td><td rowspan="3"></td><td>Signature:</td><td rowspan="3"></td></tr><tr><td>Printed Name/Agency:</td><td>Printed Name/Agency:</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:</td><td rowspan="3"></td><td>Signature:</td><td rowspan="3"></td></tr><tr><td>Printed Name/Agency:</td><td>Printed Name/Agency:</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:</td><td rowspan="3"></td><td>Signature:</td><td rowspan="3"></td></tr><tr><td>Printed Name/Agency:</td><td>Printed Name/Agency:</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:</td><td rowspan="3"></td><td>Signature:</td><td rowspan="3"></td></tr><tr><td>Printed Name/Agency:</td><td>Printed Name/Agency:</td></tr><tr><td>Reason:</td><td>Reason:</td></tr></tbody></table>

Case ID: 90A-M-3151227 1B: IO Barcode: ∈65I6203

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