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Complaint Form © . @ FD-71 (Rev. 4-16-82) - . ° o . ~ NOTE: Hand print names legibly; handwriting satisfactory for remainder. + - Indices: © Negative © See below . Subject’s name and aliases . Character of case. . au 16d UI Ke . . , Complainant © Protect Source b6 b7Cc Complaint received b b7D oO | © Personal fReTelephonic Date -ALBttime pan Address q Complainant's address and telephone number bé - b7D ~: « Scars, marks or other data a b6 Sub yeA + lb = ‘os b7C . , Subject’s Description Facts of complaint . b6 and MISTS one ‘BIC wrod : cL Motel lo oo le b7D ‘b6 b7c na mira Tag 6 - D ®&. tes oe OP pes wrbTc as conneete ba ’ . tebos bw 7 laaole =—__ IoYA-SE-BI = | ot paprtoAtter | Rr, eon will A liger patches sted) Leocaka Action Recommended