D-515 (Rev. 12-19-06) ® Accomplishment Report ; Date Prepared

q 3 ’ D-515 (Rev. 12-19-06) ® Accomplishment Report ; Date Prepared Squad supervisor approval (Accomplishment must be reported and loaded into Date Loaded (please initial) ISRAA within 30 days from date of accomplishment) Investigative Assistance or Technique Used 4. 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, D for corresponding FO Accomplishment involves: (check all that apply) Drugs A Fugitive Bankruptcy Fraud Computer Fraud/Abuse Corruption of Public Official Money Laundering Sub invest Asst by FO(s) File Number E-MM- lok 062 Stat Agent Soc. Sec. No. yo oe — | LOR ERA | Rate FO AT Rale FO AT Rate FO IAT Rate FO IAT A [riconvest || [PonReoisers | IM Ncavcy vicar] —| [| erao cover | ims asl PexsuR/Fiso| | | seoenWoren| — fois ene sca | [exsuRi rn | lf stow voney | ferraa, |_| |_| 7 To 7 _ al ml | | FTsocAsst | fous mo | ion. | [iae. 0k eam] | |vco-crovnit] —_fvenrariabex] | |__| J. Civil Rico Matters Date: Also complete “Section G" Other Civil Matters Date: Fs | er ee pia - - id | vom: A. Complaint / Information/ Indictment ClFederat [Local [J International Complaint Date: F, Conviction (Federal CitLecal {7 Internationa! Conviction Date:, Check if Civil Rico Complaint Subject Description Code +(___5 Judgment — ——— ——.—_* . —— eed Judicial Outcome__.___.__*x Information Date: or oF, G, r-Inciude Agency Code Amount $ Indictment Date: = Felony or 4 nial Suspension: Years Months Plea or Tria B. Locate / Arrest State: (Federal ([]Locat [Intemational - Subject Priority, A [1B Oc K, Administrative Sanction Date: Subject Description Code : Type: Length: Judicial District: G, U.S. Code Violation Required for sections A, B, F and J Suspension _["] Permanent Locate Date: (Federal Only) Debarment or Arrest Date: Titte Section # Counts Injunction Year. Months (2 Subject Resisted Arrest (J Subject Arrested was Armed L. Asset Seizure Date: Asset Forfeiture Date: CATS # Mandatory —_/__EE Circte befow one of the three asset forfeiture: Admin, Civil Judicial, or Criminal C. Summons Date: (Federal [7] Local Do not indicate $ value in Section D . Recovery / Restitution / PELP'X []Federal [local [J Intemational Recovery Date: Code ® v Amount $ Code*__ sy) =Amount $ Restitution Date: H. Sentence Date: Sentence Type: . M. Acquittal/ Dismissal/ Pretrial Diversion (Circle one) Date: In Jail: Years, Months Suspended: Years__t_._. Months___. N. Drug Seizures “ Date: [) Court Ordered [[] Pretrial Diversion Probation: Years, Months__ Drug Code * Code * v Amount $ Fines: $ ae Code PELP Date: : Do nat indicate $ in Section D Code * Y Amount $ |. Disruption/Dismantlement: E, Hostages(s) Released Date: Disruption Date: O. Child Victim Information Released by: [] Terrorist [1] Other Child located / identified Date: by 20 og Ktiving _ {Deceased Dismantlement Date: Number of Hostages: Completion of FD-515a Side 2 Mandatory > P, Subject Information - Required for all blocks excluding block D (Recovery/PELP), blocks E, |, Land N fe eS OE For Indictnients/Convictlons only: fi , oO Subject related to an LCN, Asian Organized Crime (AOC), Italian Organized Crime (IOC), Russian/Enstern European, Caribbean, or Nigenan Organized Crime Group = Complete FD-515a, Side 1 Blocks A-E mandatory, F-H as appropriate. oO Subject ralated to an OC/Drug organization, a VCMO Program National Gang Stralegy target group, or a VCMO Program National Priority Initiative target group - Complete FO-515a, Side 1 Blocks A-C only, x Additional information may be added by attaching another form or a plain sheet of paper for additional entries. Sofia NOSED Ae e See codes on reverse side. | ~ Requires that an explanation be attached and loaded into ISRAA for recovery over $1 m and PELP over $5 m, disruption, dismantlement, and drug seizures. VE MU-7198062- (65 HOUSE_OVERSIGHT_021590