-Mal-iptoGa.--mqr Field Office Acquiring Evidence (Y161 / PR c Rif Serial # of Originating Document Date Received S)63,2( t au_ From (Name of Conutbstoriintervmwe) (Address) By To Be Returned 0 Yes • O1C) Receipt Given 0 Yes air Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) Federal Rules