) File Number Field Office Acquiring Evidence Serial ft of Originating Document " Date Received V lqrl t1 o S From b PESc-F-A L (Name of Contnbutor/INernewee) (Address) (City and State) By To Be Retunusd K Yes ❑'ho Receipt Given K Yes K Grand Jury Material - Disseminate Only Pursuant to

144-7 %Ay vv-V -P Serial # of Originating Document Date Received U C/7—C7-7_ cr7 From — •(Nr4=.\- % L a_ (Name of Contributor) (Address of Contnbutor) tcitv and State) A net By To Be Returned 0 Yes 0 No Receipt Given 0 Yes 0 No Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) Fe