e Number C-07/4 /Can 2- fr l A. it? Field Office Acquiring Evidence Serial # of Originating Document =Received From _I ovhda //, (Nara: of Contributorfintaviewee) (Address) By S/}' (City and State) To Be Returned 0 Yes reNo Receipt Given 0 Yes l' No "strand Jury Material -Disseminate Otiv_Pursuatit