cquiring Evidence 3 I F. tat - log —rni41 t\m1/4-t_t Pbc_24- Serial # of Originating Document Date Received Q-F•C t From (Name oteontnbuior/Interviente) (Address) • By SPj Torn:Returned O Yes • Receipt Given O Yes o' -TAY Grand Jury Material -Disseminate Only Pursuant to Rule 6 (e) Federal