6.7t44-,1/4/ 4 77.4/t If eterrat /4-6_ F13-340 (Rev 4-11-03) / File Number VC "WV- it go 2- ) 1 Field Office Acquiring Evidence Serial /I of Originating Document (p7 Date Received GY/Ru/RcrO7 From atC.+4-4 BC.fiCrr Cs 4 ry atilt 77( D rehenairx.) (Name of Contribusar/Intaviewoc) (Address) (City and State) By To Be Returned O Yes No Real t Given 0 Yes No Cgrand IllaiviateriaLThaaanbutteDniv Pursuant to Itukb.fra--2 Federal Rules of Criminal Procedure [70 Yes O No Federal Taxpayer Information (F71) O Yes d No Title: Reference: (Communication Encbsing Material) Description: 0 Original notes re interview of Pna Rtr 4c44 to. °gnat r• 4 ,cry LAsicritii<-4-113- mss MM16-31E-MM-108062-GJ-1A SEC 004 SER1A17-1A19-000425 LI OOO25362 EFTA01250319