Evidence ei\,4 \1\. I P? RA- Serial # of Originating Document Date Received 9 / 1 7-4 c)L From QickinR)—Qa&-LL Rit_0:0-U-NUetoovc\-- (Name of Conttibutorantervinste) (Address) By To Be Returned 0 Yes Receipt Given 0 Yes No Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) Federal Rules of Cri