Seattle, Washington FBI Bureau File - Paperless Archives

FD-515 (Rev. 12-19-06)
~ Squad supervisor approval
~ (please initial)
Accomplishment involves:
(check all that apply)
I File Number J
:>([C-1i-Z~ p.s;;z._
Drugs
D
A Fugitive D Stat Agent Soc Sec. No. I
Bankruptcy Fraud D
Computer Fraud/Abuse D
Corruption of Public Official D
Stat Asent Name
Money Laundering D
Sub Invest Asst by FO(s) D
I
RA
Asst. FO(s) ____ I
. A. B. C. D."
Squad
Task Force
Assisting Agents Soc. Sec. No. x
Assisting Agencies x °
Name:
1. 2.
2. Name:
1.
Accomplishment Report
(Accomplishment must be reported and loaded into
ISRAA within 30 days from date of accomplishment)
Investigative Assistance or Technique Used
Date Prepared --z::-r-:-"':P7":::''':::?
Date Loaded --''''--4-''''''''-11-
Date Loader's "m~~-:::....,.4-_
1. Used, but did not help 3. Helped, substantially
2. Helped, minimally 4. Absolutely essential
For Sub. Invest. Assist. by other FO(s) indicate A, B, C, 0 for corresponding FO
A. Complaint /Information/lndictment
D Federal D Local D Intemational
Complaint Oate: _________
Check if Civil Rico Complaint D
Information Oate: _________
F. Conviction A Civil Rico Matters Oate: _____ _
D Federal ~ocal D Intemational ./ Also complete ·Section G"
Conviction Oate: ,(/Z"2.../0.T Other Civil Matters Oate: ____ _
Subject Description Code ~_). Judgment _______-0
/" Judicial Outcome ________ 0 x
For 6F, G, H-Include gency Code
~ Amount $ ___________
Indictment Oate: _________ ~elony or D Misdemeanor Suspension: Years __ Months __ _
r------------------i ~Iea or DTrial
B. Locate / Arrest Stat( h. ",4 Judicial District:
K. Administrative Sanction Oate: ____
.?
Subject Description Code ___•
D Federal D Local D Intemational
G. U.S. Code Violation / Type: Length:
Subject Priority: DAD B DC
Required for sections A, B, F and J / § Suspen'sion D Permanent
Locate Oate:
Arrest Date:
D Subject Resisted Arrest
D Subject Arrested was Armed
C. Summons Date: ________ _
D Federal
D Local
O. Recovery / Restitution / PELP X
D Federal D Local D International
Recovery Date: ________ _
Codeo __ ./ Amount $ ____ _
Code 0 __ ./ Amount $ ____ _
Restitution Oate: ________ _
D Court Ordered D Pretrial Diversion
Codee __ -.I Amount $ _____
PELP Oate: __________
(Federal Only) ./ Debarment or
Title Section /# Counts Injunction Year __ Months __
Ch;.> 2.# 11-=&)!J& 0 'B'
~"
/-
L. Asset Seizure Oate: _______ _
Asset Forfeiture Date: ______ _
CATS # Mandatory ______ _
Circle below one of the three asset forfeiture:
Admin, Civil Judicial, or Criminal
. / / L ~,,,, Do not indicate $ value in Section 0
H. Sentence Date: // L'Z.LIS ~
S t T
~.5 i. ~ ° M. Acquittal/ Oismlssalf Pretrial Diversion
en ence ype:
In Jail:
,--"r---
Years P~onths~
/
suSpend~Yeal'S- Monthspr~on:
/ines:
Years ___ Months __ _
$ _________ _
Code 0 __ -.I Amount $ I. Oisruption/Dismantlement: -.I
(Circle one) Date: _______ _
N. Orug Seizures -.I
Oate: _____ _
DrugCodeO _________ ~----__ ___
Weight ______ Code 0 ____ _
FDIN __________ _
Do not indicate $ in Section D
E. Hostages(s) Released Oate: ______ _
Released by: D Terrorist D other
Number of Hostages: ___________ _
Disruption Date: _________ _
Dismantlement Date: ________ _
Completion of FD-515a Side 2 Mandatory
O. Child Victim Information
Child located / identified Date:, ____
D living D Deceased
P. Subject Information· Required for all blocks excluding block 0 (Recovery/PELP), blocks E, I, Land N
Date of Birth
Social Security No. (if available)
For lndletmenlstConvictions only:
D Subject related 10 an LCN. Asian Organized Crim