This document is an FBI form FD-340 (Rev. 4-11-03) used for evidence acquisition. It records a file number 31ε-μμ-108062-14128, with the acquiring field office as MM/PBCRA, and indicates 'VARIOUS' for the date received. The form also notes 'Original notes re interview of Scaphical tite ON DOB' as a description, and contains redactions for sensitive information.
| Name | Role | Context |
|---|---|---|
| SA | Agent/Officer |
Signature/initials of the person completing the form
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| Location | Context |
|---|---|
|
Field Office Acquiring Evidence
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