FBI - Miami

Name/Squad: [NNN Fr e4

16320 NW 2nd Avenue

N. Miami Beach, FL 33169-6508

FOR INTERNAL USE ONLY

TQ: DAlbany —1 Houston —1 Norfolk J Fort Pierce, RA Via FBIHQ
* Albuquerque Indianapolis = —1Oklahoma City CJ Homestead, RA

CIAnchorage Jackson = Omaha Key West, RA | ©DAbuDhabi Copenhagen Riyadh
Atlanta Jacksonville Philadelphia J West Palm Beach, RA see rey Rome
Baltimore Kansas City Phoenix —- — i" 1s Abbe —oon Kou - oon Salvador
Birmingham = Knoxville Pittsburgh i 5 - i “ie vy C2 Santiago
Boston = Las Vegas = Portland = Azkara — Jakarta [Santo Domingo
Buffalo = Little Rock Richmond Astana Kabul C1Sarajevo
CiCharlotte Los Angeles OO Sacramento 3 Athens Kuala Lumpur JSeoul
CIChicago 3 Louisville 1 Samt Lows 3 Baghdad CIKyiv [J Singapore
CICincinnati Memphis = Salt Lake City 1 Bangkok Lagos Sofia
CICleveland 1 Miami [San Antonio [1 Beijing = London [J Tallinn
Columbia = Milwaukee 3 San Diego [3 Berlin Madrid I Thilisi
CDallas CI Minneapolis San Francisco CI Bem SE Menila CI Tel Aviv
Denver = Mobile 1San Juan 1 Bogota CIMexico City Tokyo
Detroit 1 Newark 1 Seattle OJ Brasilia CI Moscow = Vienna
El Paso New Haven [Springfield = podeelow £3 Naarooi bi — aaw
CIFBIHQ New Orleans [Tampa =o —-— = pa
Honolulu New York City - Washington Field — p . | X Panama City

CI Butte OSC [3 Quantico (CIRG) ~~ 3 Savannah OSC CJ Buenos Aires [J Paris

3 Clarksburg (CJIS) 3 Quantico (Training) =] Winchester (RMD) 1 Carro J Phnom Penh

[J Pocatello (PSCU) 3 Quantico (ERF-OTD) 43 J Canberra J Pretoria

J Quantico (Lab) 3 Caracas 3 Rabat
(CHECK ONE)

UNCLASSIFIED, NOT SENSITIVE
SENSITIVE, BUT UNCLASSIFIED

EICONFIDENTIAL
COSECRET

Mail AMlanagement Program
&11

EFTA00006107


id

Complaint Form
FD-T1 (Rev. 4-13-97)

NOTE: Hand prinl names legibly; handwriting satisfactory for remainder.

Indices: [| Negative [] See below

Subjects name and aliases Chanscter of case

1 - | \ : \ -
ronal EY Telephonic Date Time
Address of Subject
{ wnpit
@ Sex
Face Lax Height Hair Bald bi Birth Date and Birthplace

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[kk i lexi Social Security Number

H Age 0 Saha Weight Ewes Complexion \ | ia ¥

“0 | Scars, marks and other dats ~

Facts of complaint
fa. | _ [ [ =: \ |
ha Cs Pula pil 3 = i rg x < iF | EE | Bada \ CRS St [a FC
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3 Pretares eX r-x. Ni a =o legla oe Nav Olin

EFTA00006108
