AME AND SIGNATURE OF SPECIAL AGENT RETURNING THE EVIDENCE DATE AND SIGNATURE OF RECIPIENT /(//7 ')C ,I) ADDRESS TELEPHONE TELEPHONE NUMBER 340 Pylocat) 4,0.4.; l'1)- ONite. , >Jw Lo, k / Ai 1/4-1 ICCC 4 EVIDENCE DESTROYED METHOD USED DATE NAME AND SIGNATURE OF PERSON WHO DESTROYED THE EVIDENC