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IA

of Custody-ELSUR Evidence En elope *
04h (Rev. 8-17-01)
sure: a Onginal 0 Duplicate [J Enhanced Original
adium: O Magnetic Tape [J Computer Disk LJ Printed Material
: = — bard -
Case File#: ] + MM f |D#: JOH

Tape/Disk#:

AgL. Supervising Title 111 Intercepts:

Ll Court Authorized Intercept - Source/Symbol#: Fs 08
vd Consensual Monitoring Intercept - CM# (if assigned): CME 55 y
ru Telephonic (TCM) [J Nontelephonic (NTCM)
If NTCM Specify Device Used: El
0 Recording of an Interview
DO Volunteered/Subpoenaed Medium - Not FBI ELS! R

LJ Other Type of Recording/Interception, Specify:

|] —a

/ / RE
Intercept Date: (()J2F [09 Place L/eST fom feacin, Fo

Data Transferred for Permanent storage - Date: 0 g &/0 4 Time: 7 - pe,
O Consensual: List Interceptees Below [] Court Authorized: Enter * See Log” Below

ca rool ley Eohwerds.,

A Lfreels A ool sue 7. 3

Signature: - Signature:
Date: Time: Hi 1€p Date: LF fh
Reason: rw'tleinet Reason =

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Date: _, 4. Loy Time: r= vie

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I Date: Ld Time, 73 Date: j Bs
# Reason: EL AAS Reason:
Signature; +] Signature: h
Date: Time: Date: CL Time

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Reason:

Wa ATER Reason: _ IIE
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