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. . ALL INFORMATION CONTAINED FD-192 (Rev. 6-30-00) © Qperem 13 UNCLASSIFIED 4 . DATE 10-26-2010 BY 60322 UC/LP/STP/KM ’ ° * 7 ‘ i 7s tad “FBFEVIDENCE DATA-LOADING FORM: * -_-Separate forms. are masidatory for evidence: seized on different dates, at different locations; by different individuals, for different.types of evidence. « wo 4 ox oa . x ft ere eS ‘ a = < a, a7 < ™ wees Se . Cn iS meee wae SE, * -# . . + a vee 2 ml * * “Types of Evidence belig submitted: Tastee ti, hoe” "aes ° of Waning - special handling “ye ee -- Genefal Evidence. ">. + Ey wth Bytes ae /O Body. Fluids _- > Oother> se. - (J Valuable’ Evidences “ | “ee TS 7. LO Whole Blood CiDrug Evidence _ O HAZMAT wate C1) caRT . _ + [) Refrigeration <.. Gl Enviro, Case ID: ., - . « | Title and Character of Case: : . 12¢6-86-%9U3 7 * Person Acquiring Evidence,» "ss a Source from Which evidence acquired: : Anticipated Disposition Date: , :’| Federal Taxpayer Information: tthe.” ~ OlYes BiNo Sealed By: {printed name] ’ Estimated Dollar Value: : y ; cake = 4, Sa ve Pn id ‘Complete Description of Evidence! (Please Print). | +o Th Hoh Soe 6 te. Selwart Freee ( Gust ots , Basten | Ce hyn . / t : 1 s ¥ x ~ edhe TO Resthen ttet a . DO PmV7, cw bk Per herr +e b cas letke nhdeesse& to e anclteseh LA wits Sg Ore, Coy howd | > ¢ . « ; buthvacis Copy regen + that eo ew This form is to be used as a data-loading form only. ECT is to discard this form when the information contained herein has been entered into Evidence Data Base.