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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 Latents FGJ Signature of Seizing Individual 4/20/2017 Req. Charging Freeze Refrigerate Printed Name/Agency: CS FBI 3:40 pm b6 Biohazard Reason: Initial Collection b7C Other Collected By: CS Agency: FBI/ Newark Relinquished Custody Date andAccepted Custody Date and Time Time b6 Signature $/13/> signature: 5/3/17 b7C Printed Name/Agency: CS FBI s.SA Printed Na FBC 10:4b4m Reason C Reason: Storage Relinguished Custody Date and Accepted Custody Date and Time Time b6 Signatur 91414 Signature b7C Printed Name/Agency Printed Name/Agency Reasoneon Reason: Choye- ory hsst Relinquished Custody Date and Accepted Custody Date and : Time Time b6 Signature: Signature: b7C Printed Name/Agency Printed Name/Agency: Reason: Resfrye esudi Suopt 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: Reason: Reason: Relinguished Custody Date and 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: 2 288A-NK-2158180 Barcode: _E525751] Case ID: 1B: This form is incomplete without reference to the FD-1087.