ffice Acquiring Evidence - 1/4-At,A - I otz o 2_. /A? Pac-.2_ Serial # of Originating Document Date Received \hst-rk6 1/4.)s - From (Name of Contnbutornn Lemma) (Address) By To Be Returned ■ Yes Receipt Given O Yes O—Hr Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) Federal Rules of C