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FEB-25-1996 19:45 FROM “Co SQUAD C-—4 TO y 9122311076 P.o1 F2-809a{Rev, 8-895) INVESTIGATIVE INFORMATION REQUEST FORM FBI, Savannah Information Technology Center 220 East Bryan Street Savannsh, Georgia 31401 > Commercial Telephone of FTS: (912) 944-0824 thru 0828 > FAX: (912) 234-1076 and (912) 231-0974 : > Secure FAX & STU I: (912) 231-1075 TO: FBI, SAVANNAH INFORMATION TECHNOLOGY CENTER pate: 1 QB\AVY | BL3-| BE Forfeiture/Seizure Related: 0 Type of Request: X FAX OG Telcal ( Mail Reply: FAX O Teleat CO) Mail equator] none a 2527 TROL vax 202 252396 vem, GA-WF-202,554 onicera: SAPETEC SS _recedencet ROUTINE Yet PRIORITY IMME AT, . Approximate turnaround tines (48 irs) (2A bre) \ aes, SEARCH CRITERIA (Attach additional sheets if necessary) Aliass _ CS: DOBI1: { f DOB2: { f SSANI; = 5 SSAN2: « : Spouse: Fugitive: (1) Yes 03-No Driver’s License #: State: RESIDENCE , , Street Address ity/State: zip] ___ Phone BUSINESS Business Name: U.S. Depart menT CH LAOC) Suet Address: 1628 L. Stre CT NW. City/State: YUNGTON DC. gi Phone: «Bussiness ID: CHECK DESIRED SEARCH PARAMETERS (Please check only those that are needed) ~ a —_——__- RS (P O1. Sppifig, Information Desited [GEN bLying indormetion /D06 {SSN )— Wheel | O CLS ° i> CLAYVENT (3 2. Determine All Individuals Associated with Social Security Number(s) {] 3. Report Validity of Social Security Number CO 4, Detetmine Who is Associated with Telephone Number(s) 1 5. Determine Address of Business/Person ( U.S. > State(s)) = 6. Determine Property Owned by Individual ¢ US. State(s)) 7. Determine Who Owns Property Listed Above Determine Who Resides at Address Listed Above O19. Determine Financial Background Info, /.¢., Bankruptcy, Judgements, Liens, UCC filings, or Lawsuits {) 10. Determine Corporate Business Info, i +., Officer, Director, Registered Agent x (Person/Business) C3 11. Customs Borler Crossings / Subject query / 1-94 info (circle one} CJ 12, Federal Prison Inmate Information {] 13. Telemarketing Complaints Reply From: FBI, Savannah Information Technology Center (SITC) Return Reply To: sac; AAD IC Atteation: Based on search onteria, marked records are od: } Possible Identifiable Records CI Brief Synopsis of Information Found © Other Pefipheral Infomnation © No Information Found Sera