Seattle, Washington FBI Bureau File - Paperless Archives

~ev. 12·19-06)
, Squad supervisor approval
(please initial)
Accomplishment Report
(Accomplishment must be reported and loaded into
ISRM within 30 days from date of accomplishment)
Date Prepared -:::~~t:--:::;II"_
Date Loaded ~~le:~W;;
Date Loader's '~",",,' ~4-_
Accomplishment involves:
(check all that apply)
Drugs
A Fugitive
D
Bankruptcy Fraud D
Computer Fraud/Abuse D
Corruption of Public Official D
Money Laundering D
Sub Invest Asst by FO(s} D
~sst. FO(s) ____ I
. A. B. C. D ..
I
D
1 File Number 61-
.5 6~':-.:s~ - 73~
Stat Agent Soc Sec Ng
RA
Assisting Agents SoC. Sec. No. x
Investigative Assistance or Technique Used
1. Used, but did not help 3. Helped, substantially
2. Helped, minimally 4. Absolutely essential
For Sub. Invest. Assis!. by other FO(s) indicate A, B, C, D for corresponding FO
b7C
1.
Name:
2.
Name:
A. Complaint / Information/ Indictment
D Federal
D Local
D Intemational
Complaint Date: ________ _
Check if Civil Rico Complaint D
Information Date: ________ _
Indictment Date: ________ _
B. Locate / Arrest
F. Conviction / .... ,-
D Federal ~ocal D Intematig.nal
Conviction 6ate~
NI-z. .. .,/
/f'B O
-...,...=--
-;g:,~
Type:
§
Suspension
Debarment
Injunction
Length:
D Permanent
or
Year __ Months __
L. Asset Seizure Oale: _______ _
Ass'et Forfeiture Oale: ______ _
CATS # Mandatory ______ _
Circle below one of the three asset forfeiture:
Admin, Civil JudiCial, or Criminal
--, 9 Do not indicate $ value in Section D
" H. Sentence Date: '2 c;>;;r- 1-----------------1
.. -
Sentence Type: -:::rS , ./ /' -
In Jail:
"
'Years Pz::> Month~
suSpende%ears ___ Months __ _
Probation.
/n~
Years ___ Months __ _
$ ________ _
I. Disruption/Dismantlement: 0/
Disruption Date: _________ _
Dismantlemen! Date: ________ _
Completion of FD-515a Side 2 Mandatory
M. Acquittal{ Dismissal{ Pretrial Diversion
(Circle one) Date: _______ _
N. Drug Seizures 0/ Oate: _____ _
DrugCode-_____ ~----
Weight ___ _
FDIN __________ _
Do not indicate $ in Section D
O. Child Victim Information
Child localed / identified Dale: ___ _
D Living
D Deceased
p, Subject Information· Required for all blocks excluding block D (Recovery/PELP). blocks E, I. Land N
Name
Date of Birth
Social Security No. (if available)
For Indictments/Convictions only:
o Subject related to an LeN, Asian Organized Crime (AOC), Italian Organized Crimo (ICC). RUS!)1arllEaslem European, Caribbean, or Nigerian OrganIzed CrIme Group.
Complele F[).515a. Side 1 Blocks A·E mandatory. F·H as approprlale.
D Subject related to an OCiDrug organization, a VCMO Program National Gang Strategy targel group, or a VCMO Program National Priority Initiative target group­
Complete FD-515a. S,de1 610cksAoC only.
x Additional information may be added by attaching another form or a plain sheet of paper for additional entries.
_ See codes on reverse side •
..!' Requires that an explanation be attached and loaded into ISRM for recovery over $1 m and PELP over $5 m. disruption, dismantlement, and drug seizures.