Seattle, Washington FBI Bureau File - Paperless Archives

1;;f·'1-1~~
Squad supervisor approval
(please initial)
Accomplishment involves:
(check all that apply)
Drugs 0
A Fugitive 0
Bankruptcy Fraud 0
Computer Fraud/Abuse 0
Corruption of Public Officials 0
Money Laundering 0
Sub InvestAsst by FO (5) 0
IAsst. FO(s) _, _, _, _
, A, B, C, D
Task Force
Assisting Agencies x.
1.
2.
1.
Name:
2.
Name: '
File Number
•
Accomplishment Report
(Accomplishment must be reported and loaded into ISRM
wilhin 30 days from date of accomplishment)
Investigative Assistance or Technique Used ,
1-Used, but did not help
3 - Helped, substantially
2 -Helped, minImally 4 - Absolutely essential
For Sub. Invest. Assist. by other FO (5) indicate A,B,C,D for corresponding FO
b6
A. Complaint i Information /Indictment
o Federal o ,Local 0 International
Complaint Date:
Check if Civil Rico Complaint 0
Information Date: ______ _
Indictment Date:
B. Locatel Arrest
o Federal 0 Local 0 International
Subject Priority: 0 A 0 B 0 C
Locate Date: ________ '
Arrest Date: ________ _
o Subject Resisted Arrest
o Subject Arrested was Armed
C. Summons Date:
o Federal 0 Local
D. Recovery/Restitutlon/PELP X
o Federal 0 Local D International
Recovery Date: , ________ _
Code • __ ./ Amount $'--__ _
Code ._' __ .! Amount $ ____ _
Restitution Date: _______ _
o Court Ordered
D Pretrial Diversion
Code • __ ./ Amount $ ____ _
PELP Date: _..,...-______ _
Code -__ .! Amount $ ____ _
E. Hostage(s) Released Date: ____ _
Released by: D Terrorist D Other
Number of Hostages: ____ --=-__
F. Conviction
o Federal D Local D International
Conviction Date: _______ _
Subject Description Code: __ • ( __ ) ..
For 6F, G, H-Include Agency Code
D Felony or D Misdemeanor
o ~Iea or D Trial
State:
Judicial District: ____
G. U.S. Code Violation
Required for sections A,B,F,and J
(Federal Only)
Title Section # Counts
H. Sentence Date: __________ _
Sentence Type: ___,___,__-
In Jail: Years ___ Months __
Suspended: Years ___ Months __
Probation: Years ___ Months __
Fines: $ ______
I. DlsrUPtion/Dlsman~lem.eJt:./
Disruption Date: ""::J.aS/D ~
Dismantlement Date: ________ _
Completion of FD-515a Side 2 Mandatory
P. Subject Information. Required for all blocks excluding block 0 (Recovery/PELP), blocks E, I, L, and N.
J. Civil Rico Matters Date: _____ _
Also Complete "Section G"
Other Civil Matters Oate: ____ _
Judgment
Judicial Outcome _________ ·x
Amount $, __________________ _
Suspension: Years __ Months ___ _
K. Administrative Sanction Dale: ____
Subject Description Code __•
Type:
Length:
Suspension D Permanent
Debarment
or
D Injunction Year __ Months __
L. Asset Seizure Date: ________
Asset Forfeiture Date: _______
CATS # Mandatory _______
Circle below one of the three asset forfeiture:
Admin, Civil Judicial, or Criminal
Do not indicate $ value in Section D
M. Acquittal/Dismissal/Pretrial Diversion
(circle one) Date: _______ _
N. Drug Selzures./ Oale:, ______
Drug Code·
Weight
Code •_____
FDIN ___________
Do not Indicate $ value In Section D
O. Child Victim Information
Child located/identified Date: _______
D Living D Deceased
Social Security No. (if available)
For Indictments/Convictions only:
D Subject related to an LCN, Asian Organized Crime (AOC). Italian Organized Crime (IOC), Russian/Eastern European, Caribbean, or Nigerian Organized Crime Group -
Complete FD-515a, Side 1 Blocks A-E mandatory, F-H as appropriate,
D Subject related to an OC/Drug Organization, a VCMO Program National Gang Strategy target group, or a VCMO Program National PrIority Initiative target group -
Com lete FD-515a Side 1 Blocks A·C onl ,
Date Preparedl-rr~~-::;-;""";
Date Loaded ~~@+-
66F-SE-88581-
X Additional information ,may be added by attaching another form or a plain sheet of paper for additional Emtrles,' '
• See codes on reverse side •
Serial No. of FD-515
.t Requires that an explanation be attached and loaded Into ISRM for recovery over $1m and PELP over $5, disruption, dlsmantlement,'and drug seizures.
1 copy to 'Ca~eAgent, - 66F-SE-79837-A'-