me Signature: 4.a.l‘/// ?: 41-1?"‘ Signature: /2-1/7-4, ha., 'kilted N Printed Na Reason: //73-vf v / Reason: g.e, ? 0., i (._ p r ut 'RellakiLed Custody Date and Time ' ccepted Custody Signature: ignature: Printed Name/Agency: rinted Name/Agency: a. Reason: Relinquished Custody Date and Ti