e Number 9kE- Field Office Acquiring Evidence 1"-A.I11/44. R C 2.4 3r Serial # of Originating Document Date Received VPrrkn 0 From (Name of Contributorfirsterviewec) (Address) (coy and Stale) By SA- IMMMIEME To Se Returned 0 Yes Eitio Receipt Given 0 Yes L7 No Grand Jury Material - Disseminate Only Pu