FD-340 (Revol-II-03) File Number Field Office Acquiring Evidence Serial # of Originating Document " Date Received \I Pc n 6 O S From e" \ kitt-k- lootc)2_. - /A A2 ( PRc_2_40t (Name of Contributonintetvxwee) (Address) (City and State) By Pt To Be Returned O Yes • U -No Receipt Given