Field Office Acquiring Evidence Serial # of Originating Document Date Received From By — /0 13 144(cuAii West- et-G,vt 3 ito‘i to A- 1141 (Nanic of Contributorilnientox) D 43, 0y (9,1-ktot6\ (A..) vi Pe), (.71, To Be Returned 0 Yes X No Grand Jury Material - Disseminate O Pug No to Ruk 6 (e) Receipt Giv