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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 b6 HAZMAT b7C Latents FGJ Signature of Seizing Individual. 4/19/2017 Req. Charging Freeze Refrigerate Printed Name/Agency: CS FFBI 6:00 pm Biohazard Reason: Initial Collection Other Collected By: CS b6 FBI/ Newark b7C Agency: Relinquished Custody Date and Accepted Custody : Date and Time Time Signature: 373/17 Signature: t1/2/5 b6 Printed Name/Agency: CS FFBI 3T 10.4bam b7C Reason:heoye Eco Reason: ae Relinguished Custody Date and Accepted Custody Date and Time Time Signature Signature Printed Name/Agency: Printed Name/Agency! FL 3.55p b6 Reason: ADeo Reason:Charyr- oOf b7C Relinguished Custody Date and Accepted Custody Date and Time Time. Signature: Signature: Printed Name/Agency: b6 Printed Name/Agency: b7C ReasonDesNo tn 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 1 Time: Time Signature: Signature: Printed Name/Agency: Printed Name/Agency: Reason: Reason: Relinquished Custody Dateand Accepted Custody Date'and Time Time Signature: Signature: Printed Name/Agency: Printed Name/Agency: Reason: Reason: Firearm Certification by (FI/SwAT) / Explosive Material Certification by (SABT): ATF Trace Form Completed: Printed Name: NCIC: Signature: Date: Case ID: 288A-NK-2158180 1 Barcode: 526 75/0 1B: This form is incomplete without reference to the FD-1087.