1 (232 k vs item (s) listed below were: Collected/Seized Received From Returned To (Name) (Street Add (City) Description of Item (s): () Dripti Ric Put AS IMEt 14 111 Received By: Received From: Printed Nameff Printed Name/ Titles EFTA00132238 90A-NY-3151227 Serial 69 FD-302 (Rev. 5