HOUSE_OVERSIGHT_021582.jpg

FD-515 (Rev 12-19-06)
Squad supervisor approval (please initial)
Accomplishment Report
(Accomplishment must be reported and loaded into ISRAA within 30 days from date of accomplishment)
Date Prepared 09/29/08
Date Loaded 9/30/08
Date Loader's Initials
b6
b7C
b7E

Accomplishment involves: (check all that apply)
Drugs
A Fugitive
Bankruptcy Fraud
Computer Fraud/Abuse
Corruption of Public Official
Money Laundering
Sub Invest Asst by FO(s)

File Number: 31E-MM-108062
Stat Agent Soc. Sec. No.
Stat Agent Name
RA: PBCRA
Squad: PB-2
Assisting Agents Soc. Sec. No. X
Name
2.
Name:

Investigative Assistance or Technique Used
1. Used, but did not help
2. Helped, minimally
3. Helped, substantially
4. Absolutely essential
For Sub. Invest. Assist. by other FO(s) indicate A, B, C, D for corresponding FO
[Table of Techniques lists: Fin. Analyst, Aircraft Asst., Computer, Consen Mon., ELSUR/FISC, ELSUR/T. III, Eng. Field Spt., Eng. Tape Ex., Legats Asst., Evid. Purchase, Inf/CW Info, Lab. Div. Exam, Lab. Field Sup, Pen Registers, Photo Cover, Polygraph, Search Warrant, Show Money, SOG Asst., Swat Team, Tech. Ag/Equip., Phone Toll Rec, UCO - Group I, UCO - Group II, UCO - Nat.Back, NCAVC/Vi-CAP, Crim/NS Intel Asst, Crisis Neg.- Fed, Crisis Neg.- Local, ERT Asst., Butte - ITC, Sav - ITC, Poc - ITC, Fl. Mon. - ITC, For. Lang Asst., Non FBI Lab Ex, Vict-Witn Coor, IO Wanted Flyer, SARs, CART, Asset Forf Prog, Forf Support Proj, TFOS/CTD, CXS/CTD, InfraGard/CyD, OFC/CID, PPP]

A. Complaint / Information/ Indictment
Federal Local International
Complaint Date:
Check if Civil Rico Complaint
Information Date:
Indictment Date:

B. Locate / Arrest
Federal Local International
Subject Priority: A B C
Locate Date:
Arrest Date:
Subject Resisted Arrest
Subject Arrested was Armed

C. Summons Date:
Federal Local

D. Recovery / Restitution / PELP X
Federal Local International
Recovery Date:
Code *____ Amount $
Code *____ Amount $
Restitution Date:
Court Ordered Pretrial Diversion
Code *____ Amount $
PELP Date:
Code *____ Amount $

E. Hostages(s) Released Date:
Released by: Terrorist Other
Number of Hostages:

F. Conviction
Federal Local International
Conviction Date:
Subject Description Code * (_____)*
For 6F, G, H - Include Agency Code
Felony or Misdemeanor
Plea or Trial
State: Judicial District:

G. U.S. Code Violation
Required for sections A, B, F and J (Federal Only)
Title Section # Counts

H. Sentence Date:
Sentence Type:
In Jail: Years Months
Suspended: Years Months
Probation: Years Months
Fines: $

I. Disruption/Dismantlement:
Disruption Date:
Dismantlement Date:
Completion of FD-515a Side 2 Mandatory

J. Civil Rico Matters Date:
Also complete "Section G"
Other Civil Matters Date:
Judgment
Judicial Outcome
Amount $
Suspension: Years Months

K. Administrative Sanction Date:
Subject Description Code
Type: Length:
Suspension Permanent
Debarment or
Injunction Year Months

L. Asset Seizure Date:
Asset Forfeiture Date:
CATS # Mandatory
Circle below one of the three asset forfeiture:
Admin, Civil Judicial, or Criminal
Do not indicate $ value in Section D

M. Acquittal/ Dismissal/ Pretrial Diversion
(Circle one) Date:

N. Drug Seizures Date:
Drug Code
Weight Code
FDIN
Do not indicate $ in Section D

O. Child Victim Information
Child located / identified Date: 6/30/08
[X] Living Deceased

P. Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks E, I, L and N
[Redacted Box] Race Sex Date of Birth Social Security No. (if available)
[Redacted Box]
[Redacted Box]

x Additional information may be added by attaching another form or a plain sheet of paper for additional entries.
* See codes on reverse side.
Requires that an explanation be attached and loaded into ISRAA for recovery over $1 m and PELP over $5 m, disruption, dismantlement, and drug seizures.

b6
b7C
Serial No. of FD-515
31E-MM-108062 - 181
HOUSE_OVERSIGHT_021582