EFTA02849343

| FD-794 (Rev. 2-7-00)       (AC) Criminal Case       Classification         (AC) Criminal OCDETF Case       (CF) Asset       (GA) SOG         (AF) FCI Case       (DD) OCDETF Group II UCO       (GC) Air Operation         (BC) Informant/CW       (BD) informant/CW Providing Drug info.       (F) FCI UCO       (J) FCI Lockout         Oraft Request       .       2. Date       .       . |                      |
|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------|
| Draft Request ? 2. Date                                                                                                                                                                                                                                                                                                                                                                       |                      |
|                                                                                                                                                                                                                                                                                                                                                                                               | 1-1                  |
| 3. Request for: ( ) Advance ( ) Expense 4. Social Security No:                                                                                                                                                                                                                                                                                                                                | 11                   |
| 5. Payee Name: 6. File No: 6. File No:                                                                                                                                                                                                                                                                                                                                                        | e i i                |
| 1 1                                                                                                                                                                                                                                                                                                                                                                                           | Amount               |
| 01 1                                                                                                                                                                                                                                                                                                                                                                                          |                      |
|                                                                                                                                                                                                                                                                                                                                                                                               |                      |
| 03                                                                                                                                                                                                                                                                                                                                                                                            |                      |
| 05                                                                                                                                                                                                                                                                                                                                                                                            |                      |
| 06                                                                                                                                                                                                                                                                                                                                                                                            |                      |
|                                                                                                                                                                                                                                                                                                                                                                                               |                      |
| 9. Total \$ 1                                                                                                                                                                                                                                                                                                                                                                                 |                      |
| 10. Justification:                                                                                                                                                                                                                                                                                                                                                                            |                      |
|                                                                                                                                                                                                                                                                                                                                                                                               |                      |
| Asset/Informant File No Symbol No<br>Payment/Code Name Period Covered to                                                                                                                                                                                                                                                                                                                      |                      |
| One Time Non-symbol Source Payment:                                                                                                                                                                                                                                                                                                                                                           |                      |
| True Name:DOB:/SSAN:<br>Date of Waiver://                                                                                                                                                                                                                                                                                                                                                     |                      |
|                                                                                                                                                                                                                                                                                                                                                                                               |                      |
| 11. Payment for reimbursable expense - forfeiture or drug related?YesNo                                                                                                                                                                                                                                                                                                                       |                      |
| 12. Requested by:                                                                                                                                                                                                                                                                                                                                                                             | 15                   |
| 14. Approval                                                                                                                                                                                                                                                                                                                                                                                  | Date                 |
| Supervisor Initials:                                                                                                                                                                                                                                                                                                                                                                          | -,                   |
| SAC / ASAC / AO / SAS Approval:                                                                                                                                                                                                                                                                                                                                                               | 1                    |
| Draft Approval Officer:                                                                                                                                                                                                                                                                                                                                                                       |                      |
| Procurement Authorization: No IT Obligation No.                                                                                                                                                                                                                                                                                                                                               |                      |
| J. J. J. J. J. J. J. No. J. L.                                                                                                                                                                                                                                                                                                                                                                |                      |
| 18. Cost Center: 19. Squad/RA: 20. Follow-up Date:                                                                                                                                                                                                                                                                                                                                            |                      |
| 21 Document No. / / 22. CONF _ C                                                                                                                                                                                                                                                                                                                                                              | OMM                  |
| 23. Draft No: 25. Cashier: 25. Cashier:                                                                                                                                                                                                                                                                                                                                                       |                      |
| 26. Settlement of Advance: Prior month Advance Balance: \$-                                                                                                                                                                                                                                                                                                                                   | a successful and and |
| This Advance: \$-                                                                                                                                                                                                                                                                                                                                                                             |                      |
| Funds Returned and/ or Cash on Hand: \$03956-                                                                                                                                                                                                                                                                                                                                                 | 340                  |
| Amount to be Reimbursed:                                                                                                                                                                                                                                                                                                                                                                      |                      |
| 27. Document No.                                                                                                                                                                                                                                                                                                                                                                              | b                    |
| 28. Draft No: 29. Date: 30. Cas                                                                                                                                                                                                                                                                                                                                                               |                      |
|                                                                                                                                                                                                                                                                                                                                                                                               |                      |
| The second second second second second second second second second second second second second second second s                                                                                                                                                                                                                                                                                |                      |
| Shaded areas for draft office use only Classification:                                                                                                                                                                                                                                                                                                                                        |                      |
| haded areas for draft office use only  Classification:                                                                                                                                                                                                                                                                                                                                        |                      |
| haded areas for draft office use only Classification:                                                                                                                                                                                                                                                                                                                                         | 2-10                 |

2

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.

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## DRAFT REQUEST FORM INSTRUCTIONS

#### REQUESTING EMPLOYEE - Complete blocks 1 to 13 as follows:

- 1 Enter Budget Category Classification to which expenses will be charged.
- 2 Current date.
- 3 Check the box to indicate if this request is for an advance of funds or for payment of an expense.
- 4 Your Social Security Account Number.
- 5 The name of the person or company that should appear on the check.
- 6 The substantive file number, or the file number of the case benefitted by a payment to an informant, asset or cooperative witness. (If more than one case, see No. 10 below)
- 7 Brief description of the type of expense to be paid.
- Amount requested for each type of expense.
- 9 Total amount requested.
- 10 Enter a brief justification for expense or advance requested. Indicate multiple cases benefitted by asset/information/CW payment if applicable. For Field Office Use Only: A justification electronic communication must be completed for informant/asset/CW expenses and placed in the applicable informant/asset/CW file, maintained in the field office.
- Check the proper answer to indicate if the requested expense is reimbursable as asset forfeiture related or as a payment for drug information.
- 12 Your name.
- 13 Your telephone number or extension.

### APPROVAL:

14 - Each request should be reviewed by the employee's direct supervisor, who should initial the form to indicate review. Confidential expenses must be approved by signature of an ASAC or above. Expense/Advance requests for the purchase of supplies or equipment must be approved by the Supply Technician prior to payment. Commercial expenses must be approved by signature of an AOSM or above prior to payment. The Draft Approval Officer may approve commercial expenses under \$50.00. Indicate the name of the FBIHQ procurement officer and telephonic authorization number (T- number), if appropriate. All advances and expenses must be approved by the Draft Approval Officer, who will complete the following parts of this form:

### APPROVAL OFFICER:

- 15 Vendor Number and Vendor Group Number.
- 16 Classify the expense using Catalog Number (CAT) and Item Number.
- 17 Obligation number if an advance is issued.
- 18 Your cost center.
- 19 Squad/RA code, if applicable.
- 20 Follow-up date for advance liquidation.

#### DRAFT CASHIER:

- 21 Document Number assigned to this transaction.
- 22 Check if this transaction is confidential (CONF) or commercial (COMM).
- 23 Draft Number.
- 24 Date issued.
- 25 Cashier initials.
- 26 Enter advance settlement information when receipts are presented and the matching expense transaction is entered. If a supplemental draft is issued, complete blocks 27 to 30.
- 27 Document Number issued to this transaction.
- 28 Draft Number.
- 29 Date issued.
- 30 Cashier initials.

| FD-794 (Rev. 2-7-00)  (AC) Criminal CaSe (AD) Criminal CoDETF Case (AF) FCI Case (BC) Informant/CW (BD) Informant/CW Providing Drug Info (BD) Informant/CW Providing Drug Info (F) FCI UCO (J) FCI Lookout                                                                                                                                                                                                                                                                                                                                                                                            |                          |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------|
| Draft Request 2. Date _ / / 2, 3, / 0, 7                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              |                          |
| B. Request for: ( ) Advance ( ) Expense , 4. Social Security No:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | ъз -2                    |
| 5. Payee Na                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           | Ъ6 −2<br>Ъ7С −2          |
| 16. Cat Item No 7. Description 8. Amount                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              |                          |
| 01<br>02<br>03<br>04<br>05<br>06<br>07                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                |                          |
| 9. Total \$ 10. Justification: 10. Justification: 10. Justification: 10. Justification: 10. Justification: 10. Symbol No. Symbol No.                                                                                                                                                                                                                                                                                                                                                                                                                                                                  | b3 -2                    |
| Payment/Code NamePeriod Coveredtototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototototo _to | Ь6 -1<br>Ь7С -1          |
| Supervisor Initials:<br>SACCASAD/ AO / SAS Approval:<br>Supply Technician Approval:<br>Draft Approval Officer:<br>Procurement Authorization:<br>15. Vendor No.<br>18. Cost Center<br>19. Squad/FA: 20. Follow-up Date: 05.101.102                                                                                                                                                                                                                                                                                                                                                                     | ЪЗ -2<br>Ъ6 -5<br>Ъ7С -5 |
| 21 Document No                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |                          |
| 23. Dratt No: 24. Date: _ 3/- 6 / 25. Cashier                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         |                          |
| 26. Settlement of Advance: Prior month Advance Balance: \$-<br>This Advance: \$-<br>Less: Receipts: \$_<br>Funds Returned and/ or Cash on Hand: \$_<br>Amount to be Reimbursed:\$-                                                                                                                                                                                                                                                                                                                                                                                                                    |                          |
| 27. Document No.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | ĩ                        |
| 28. Draft No: 29. Date: 3/3//27 3                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |                          |
| Shaded areas for draft office use only Classification: 0394                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           | 56-351                   |

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|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------|------------------------------------------|------------------|----------------------|-----------------------|---------------------|-------------------------------|--------------|-------------------|------------|
| U.S. Department of Ju                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           | Istice                                                        | •, •                                     | •                |                      |                       |                     | information                   |              | ation,            |            |
| Washington, D.C. 2053                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           |                                                               | 13 1 17 99 T                             | OUT              | Purc                 | hase Orde             | r. Rece             | iving Report                  | <u></u>      |                   |            |
| THE PARTY AND A REAL PROPERTY OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA OF A DATA |                                                               |                                          | C-RO-GLIMMAN AND |                      | CHE STREET, HE CANNED | RUNDE-CON           | ALCHORD AND                   |              | and and an income | A PERMIT   |
| This form shall only be used who                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                | in requesting finuncial records of ind                        | ividuals and parmersbu                   | ps of five o     | r fewer ind          | Sviduals.             |                     |                               |              |                   |            |
| 1 Purchase Order Number:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        |                                                               | 2 Date Order Prepa                       | ared.            |                      |                       | 36                  | ase Number:                   |              |                   | b3         |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      |                       | ĮĮ                  | (7)                           |              |                   |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 | Plance                                                        | ction A - Authori<br>include PV          |                  |                      |                       |                     |                               |              |                   |            |
| 4 Name and Address of Fini                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      | incial Institution:                                           | mendue 1 11                              | 10 011           | paying               |                       |                     |                               |              |                   |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      |                       | L                   |                               |              |                   |            |
| 5 D                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                                                               |                                          |                  |                      |                       |                     |                               | 6 Return     | Date:             |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      |                       |                     |                               |              |                   |            |
| 7 Remarks:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      |                                                               |                                          |                  |                      |                       |                     |                               |              | •••               |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      |                       |                     |                               |              |                   |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      |                       |                     |                               |              | Comments          | ъ6 -2,-    |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      | 9 Telephon            | e Numhei            | r.                            | 10 Dale o    | I TEQUESI.        | b7C -2     |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 | ,                                                             |                                          |                  |                      | Ļ                     |                     |                               | ┢╧┦          | 21.7.0 0          | <u> </u>   |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               | Section B - Fina                         |                  |                      |                       | 5                   | To Ba Amached                 |              |                   |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 | No Payment Shall Be Ma                                        | de Uniess Expenses                       | Are Rem          | IZED Belo            | w Or On To            | ar Porn             |                               |              |                   |            |
| 11 Service/Financial Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     | is Provided:                                                  |                                          |                  |                      | Quant                 | ity                 | Unit P<br>Cost                | Per          | Amou              | nt         |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      |                       |                     |                               |              | to accounte       |            |
| I hereby certify that the se<br>(checking savings, share,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       | ervices provided below were<br>loan, or credit card) of indiv | not performed rel<br>vidual(s) or partne | rship(s)         | ny corp<br>of five d | fewer part            | ni vențui<br>iners. | es, etc., and p               |              | to accounts       |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      |                       |                     | VEDE DEEO                     | DE DAVI      | ENT CAN           |            |
| THE TAX IDENTIFICAT<br>MADE. TAX IDENTIFI                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       | TION NUMBER FOR THE                                           | FINANCIAL INS                            | TITUTI           | UM NC                | ST BE INC             | LUDED               | HEKE BEFO                     | RE PAIN      | ENI CAN           | bc 1<br>b3 |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      |                       |                     |                               | ,            |                   | b6         |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 | SEA                                                           | RCH & PRO                                | CESS             | NG                   |                       |                     |                               |              |                   | ъ7с        |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      |                       |                     |                               |              |                   |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 | RI                                                            | EPRODUCTI                                | ON CO            | DST                  |                       |                     |                               |              |                   |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      |                       |                     |                               |              |                   |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               | M                                        | AIL CO           | DST                  |                       |                     |                               |              |                   |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      |                       |                     |                               |              |                   |            |
| ;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |                                                               |                                          |                  |                      |                       |                     |                               |              |                   |            |
| 12                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              | atution Official:                                             |                                          |                  | 13 024               | 129/1                 | N                   | Total Arnou<br>By Financia    |              |                   |            |
| -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               |                                                               |                                          |                  | 100                  | 1-44                  | ,U                  | 116 Disaliowar                |              | ┟└───             |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               | ceiving Report                           |                  |                      | 1                     |                     | (See Allac                    | hed)         |                   |            |
| 14 I certify that the articles                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  | and services listed were receive                              | d:                                       | 2                | 15 Det               | Received:             |                     | 17 Net to<br>Financial        |              |                   |            |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                                               |                                          |                  |                      |                       | 10.0                | Institution<br>gnature of App | avian Offic  | [                 |            |
| 18 Right to Financial Priva<br>(12 U.S.C. 3401-3422) I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          | cy Act - Public Law 95-630<br>Request Pursuant To: (Check O   | ne Only)                                 |                  |                      |                       | 19 5                | gnature of App                | oving Ottic  | iai               |            |
| SECTION                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         | -1                                                            |                                          |                  |                      | OBJECT<br>CLASS       |                     |                               |              |                   |            |
| 3404                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            | Customer Authorization                                        |                                          |                  |                      | 2540                  | 20 A                | ccounting Class               | ification Co | de                |            |
| 3405                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            | Administrative Subpoena o                                     | r Summons                                |                  |                      | 2541                  | FYF                 | C 1 2                         | 3            | 4 5               | PROJ       |
| 3406                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            | Search Warrant                                                |                                          |                  |                      | 2542                  |                     | TTT                           |              |                   |            |
| 3407                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            | Judicial Subpoena                                             |                                          |                  |                      | 2543                  |                     |                               |              |                   |            |
| 3408                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            | Formal Written Request                                        |                                          |                  |                      | 2544                  | 21 Se               | chedule and Vo                | ucher Numb   | er:               |            |
| 3413 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          | Grand Jury Subpoena                                           |                                          |                  |                      | 2545                  | DC                  | ŧ                             |              |                   |            |
| 3414                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            | Special Procedures                                            |                                          |                  |                      | 2546                  |                     |                               |              |                   |            |
| 22 Remarks:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |                                                               |                                          |                  |                      |                       |                     |                               |              |                   |            |

03956-355

FORM OBD-211

| FD-794 (Rev. 2-7-00)                                                                                                                                                                                                                                        |                                                                          |
|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------|
| (AC) Criminal Case       (CF) Asset         (AD) Criminal OCDETF Case       (DC) Group II UCO         (AF) FCI Case       (DD) OCDETF Group II         (BC) Informant/CW       (E) Group I         (BD) Informant/CW Providing Drug info.       (F) FCI UCO | (GA) SOG<br>(GB) OPS<br>(GC) Air Operation<br>(H) SSG<br>(J) FCI Lookout |
| Draft Request 2. Date                                                                                                                                                                                                                                       |                                                                          |
| B. Request for: ( ) Advance ( ) Expense 4. Social Security No:                                                                                                                                                                                              | t A It I I I I                                                           |
| 6. File No: مَنْ اللَّهُ اللَّهُ اللَّهُ اللَّهُ اللَّهُ اللَّهُ اللَّهُ اللَّهُ اللَّهُ اللَّهُ اللَّهُ اللَّهُ                                                                                                                                            | 1.0                                                                      |
| 6. Cat Item No 7. Description                                                                                                                                                                                                                               | 8. Amount                                                                |
| 01                                                                                                                                                                                                                                                          |                                                                          |
| 02                                                                                                                                                                                                                                                          |                                                                          |
| 04                                                                                                                                                                                                                                                          |                                                                          |
|                                                                                                                                                                                                                                                             |                                                                          |
| 07                                                                                                                                                                                                                                                          |                                                                          |
|                                                                                                                                                                                                                                                             | 9. Total \$                                                              |
| 0. Justification:                                                                                                                                                                                                                                           |                                                                          |
|                                                                                                                                                                                                                                                             |                                                                          |
| sset/Informant File No Symbol No                                                                                                                                                                                                                            | to                                                                       |
| ayment/Code NamePeriod Covere                                                                                                                                                                                                                               | dto                                                                      |
| rue Name: DOB: / / S                                                                                                                                                                                                                                        | SAN:                                                                     |
| ate of Waiver://                                                                                                                                                                                                                                            |                                                                          |
| 11. Payment for reimbursable expense - forfeiture or drug related?Yes 💢 N                                                                                                                                                                                   | lo                                                                       |
| 12. Requested by: 13. Telephone No: (                                                                                                                                                                                                                       | 21) 2: 116                                                               |
| 14. Approval                                                                                                                                                                                                                                                | Date                                                                     |
| Supervisor Initials:                                                                                                                                                                                                                                        | 7                                                                        |
| SAC / ASAC / AO / SAS Approval:                                                                                                                                                                                                                             | X 1 117                                                                  |
| Supply Technician Approval:<br>Draft Approval Officer:                                                                                                                                                                                                      |                                                                          |
| Procurement Authorization: No                                                                                                                                                                                                                               |                                                                          |
| 5. Vendor No. Group 17 Obligati                                                                                                                                                                                                                             | ön No.                                                                   |
| 18. Cost Center: 19. Squad/RA: 20. Follow-up                                                                                                                                                                                                                | Date:                                                                    |
| 21 Document No.                                                                                                                                                                                                                                             | 22. CONF                                                                 |
| 23. Dráť Nó; 24. Date: 25. Cashie                                                                                                                                                                                                                           |                                                                          |
|                                                                                                                                                                                                                                                             |                                                                          |
| 26. Settlement of Advance: Prior month Advance Balance: \$<br>This Advance: \$                                                                                                                                                                              | b3<br>b6                                                                 |
| Less: Receipts: \$                                                                                                                                                                                                                                          | 03956-358 ь7с                                                            |
| Funds Returned and/ or Cash on Hand: \$Amount to be Reimbursed:\$                                                                                                                                                                                           |                                                                          |
| 27. Document No.                                                                                                                                                                                                                                            |                                                                          |
| 28: Draft No:                                                                                                                                                                                                                                               | -3                                                                       |
| haded areas for draft office use only                                                                                                                                                                                                                       |                                                                          |
| Classification:<br>Classified By:                                                                                                                                                                                                                           |                                                                          |
| ue Copy - Administrative/Case File Declassify on:                                                                                                                                                                                                           |                                                                          |
| 3/0                                                                                                                                                                                                                                                         | - MM-108062-07                                                           |

EFTA02849348

| FD-794 (Rev. 2-7-00)  I. Classification 3/6  (AC) Criminal Case (AD) Criminal OCDETF Case (AD) Criminal OCDETF Case (AC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) Informant/CW (BC) | DG<br>25<br>7 Operation<br>36<br>21 Lookout |         |
|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------|---------|
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                | 23107                                       |         |
| 3. Request for: ( ) Advance ( -/ Expense 4. Social Security No:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                |                                             | b.<br>b |
| 5. Payee Name: 6. File No: 31 E- MM                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            | 08062                                       | b       |
| 16. Cat Item No 7. Description                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 | 8. Amount                                   |         |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                |                                             |         |
| 07                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             |                                             | 1       |
| 9. T                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           |                                             |         |
| 10. Justification:<br>assist in case investigation:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |                                             |         |
| Asset/Intermant File No Symbol No<br>Payme::::::::::::::::::::::::::::::::::::                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 |                                             |         |
|                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                |                                             |         |
| 11. Payment for reimbursable expense - forfeiture or drug related?Yes XNo                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      |                                             |         |
| 12. Requested by: 13. Telephone No:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            |                                             | ь<br>Ь  |
| 14.<br>Supervisor Initials:<br>SAC ASAC AO / SAS Approval:<br>Supply Technician Approval:<br>Draft Approval Officer:<br>Procurement Authorization:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             | Date<br>126/87<br>18007<br>130(2-1          |         |
| 15. Vendor No. Group 17 Obligation No. No.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |                                             | b<br>b  |
| 18. Cost Center: 19. Squad/FA: 20. Follow-up Date                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              | 3/01/077                                    | ь       |
| 21 Document No. 22. C                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          | ONF COMM                                    |         |
| 23. Draft No 24. Date: 3-07 25. Cashie                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         |                                             |         |
| 26. Settlement of Advance: Prior month Advance Balance: \$<br>This Advance: \$<br>Less: Receipts: \$<br>Funds Returned and/ or Cash on Hand: \$                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                |                                             |         |
| Amount to be Reimbursed:\$                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     |                                             |         |
| 28. Draft No: 29. Date: 2 31/77                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                |                                             |         |
| Shaded areas for draft office use only                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         |                                             | _       |