FD-340 (Rev. 4.11.0)) File Number Field Office Acquiring Evidence Serial it it of Originating Document Date Received V 0.410 From 90.1 (Name orConuibutor/Intervietsee) (Address) By triiv and Stale) To Be Returned O Yes • Receipt Given O Yes . Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) F