ame/Agency: Reason: Reason: Relinquished Custody Date and Tiara Accepted Custody Date and Time Signature: Signature: Printed Name/Agency: Printed Nerne/Agency: Reason: Reason: Case ID: 31 E-MM-108062 03: 7 Barcode: E4229234 This form is incomplete without reference to the FD-1087. SDNY_GM_02753577