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FD-1004 FEDERAL BUREAU OF INVESTIGATION Rev. 7-7-2016 EVIDENCE CHAIN OF CUSTODY Evidence Type: General Drugs Firearms/Weapon Item # Digital Valuables Firearms/Other Special Handling Instructions Initial Receipt Date and Time hAzmAT Latcnts j FGJ Signature of Seizing Individual! 4/21/2017 Req. Charging Frceze Refrigeraic Printed Name/Agency: CS FFBI 10:00 am Biohazard Reason: initial Collection b6 Other b7C Collected By: Cs Agency: FBI / Newark Relinquished Custody Date and Accepted Custody Date and Time Time Signature: 5/3/17 Signature: 5/3/17 b6 Printed Name/Agency: CS FBI 0:46 AM Printed Na |0.46am b7C Reason: e f Reason: Relinquished Custody Date and Accepted Custod? Date and Time Time Signatur ttib Signature: Printed Name/Agenc Printed Name/Agency Reason:W J.5S|n Reason: b6 b7C Relinquished Custody Date and Accepted Custody Date and Time Time Signature Signature: Printed Name/Agency: Printed Name/Agency: b6 Reason: D oy b7C Rcason: Relinquished Custody Date and Accepted Custody Date and Time Time Signature: Signature: Printed Name/Agency: Printed Name/Agency: Reason: Reason: Relinquished Custody Date and Accepted Custody Date and Time Time Signature: Signature: Printed Name/Agency: Printed Name/Agency: Reason: Reason: Relinquished Custody Date and Accepted Custody Date and Time Time Signature: Signature: Printed Name/Agency: Printed Name/Agency: Rcason: Reason: Firearm Certification by (FI/SWAT) / Exptosive Material Certification by (SABT): ATF T`race Form Comp!eted: Printed Name: nciC: Signature: Date: 3 Barcode._F5257512 1B: This form is incomplete without reference to the FD-1087