HOUSE_OVERSIGHT_021574.jpg

FD-515 (Rev. 12-19-06)
Squad supervisor approval (please initial) [Empty Box]
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 [Redacted]

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 [Redacted]
RA: PBCRA
Squad: PB-2
Assisting Agents Soc Sec No [Redacted]
1 [Redacted]
Name [Redacted]
2. [Redacted]
Name: [Redacted]

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
[Grid of techniques listed: Fin. Analyst, Aircraft Asst., Computer, Consen Mon., ELSUR / FISC, ELSUR / T. III, Eng. Field Spt., Eng. Tape Ex., Legats Asst., Evid. Purchase, 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, Ft. 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]

[Right Margin Codes: b6, b7C, b7E]

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 ______ *x
Amount $ ______
Suspension: Years ______ Months ______

K. Administrative Sanction Date: ______
Subject Description Code ______ *
Type:
[ ] Suspension
[ ] Debarment
[ ] Injunction
Length:
[ ] Permanent
or
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 Name Block]
Race * [Blank] Sex [Blank] Date of Birth [Blank] Social Security No. (if available) [Blank]

[ ] Subject related to an LCN, Asian Organized Crime (AOC), Italian Organized Crime (IOC), Russian/Eastern European, Caribbean, or Nigerian Organized Crime Group - Complete FD-515a, Side 1 Blocks A-E mandatory, F-H as appropriate.
[ ] Subject related to an OC/Drug organization, a VCMO Program National Gang Strategy target group, or a VCMO Program National Priority Initiative target group - Complete FD-515a, Side 1 Blocks A-C only.

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.

Serial No. of FD-515 [Blank]
31E-MM-108062-178
HOUSE_OVERSIGHT_021574