"Ag/ri
3 LiSe
Printed
Reason
Rang
Date and
Time
Signatu
Wzi
12-1•24r .
Printed
Reason
Relincp
Date and
Time
Signatu
Printed
Reason
Relinql
Date and
Time
Signatu
q/2/.24
aswy)
Printed
Reason
Relinquished Custody()
Date and
Time
Accepted Custody 1/4—)
Date and
Time
Signature: