0 Computer Disk 0 Printed Material Case Filers 1X - MS1 - tnIa-7 IDA it 4 Cast Agt. Tape/Disk*: Agt. Supervising Title III Intercepts: O Court Authorized Intercept Source/SymboIN: • Consensual Monitoring Intercept- CMN (if assigned): Crtii ,64P piSe Telephonic (TCM) 0 Nontelephonic (N

0 Computer Disk 0 Printed Material Case Filers 1X - MS1 - tnIa-7 IDA it 4 Cast Agt. Tape/Disk*: Agt. Supervising Title III Intercepts: O Court Authorized Intercept Source/SymboIN: • Consensual Monitoring Intercept- CMN (if assigned): Crtii ,64P piSe Telephonic (TCM) 0 Nontelephonic (N

0 Computer Disk 0 Printed Material Case Filers 1X - MS1 - tnIa-7 IDA it 4 Cast Agt. Tape/Disk*: Agt. Supervising Title III Intercepts: O Court Authorized Intercept Source/SymboIN: • Consensual Monitoring Intercept- CMN (if assigned): Crtii ,64P piSe Telephonic (TCM) 0 Nontelephonic (N

s. (check one) do include do not include Psychiatric information. (check one) To O Healthcare Provider K Insurance Company or Designee O Attorney O Court K Law Enforcement Other Personal Assistant Name: Lesley Groff Address 9 East 71st Street, NY, NY 10021 O Employer Reason for Disclosure 0 Pa

ght 180 In Hair: Place of Binh: United States Of Arnerica (usa) Currently on Probation/Parole: El No O Yes Probation Type: psate K Fedora! O Court, State city Officer Name: Greg Eyes: Blue Phone: ( ) Officer Nerve: Phone: ( ) Officer Name: Phone: ( Couwy Out of State Travel Inform