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EFTA00005774
DMV Photo
Subject Information
Name:
ClientiD:
Case Number:
SI
DMV Transaction Number:
1069006
DMV Transaction Date/Time: 2019-06-05 18:36:18:690
EFTA00005775
Last updated: 01108/2017
Request for NYS DMV P OTO IMAGE
To:
New York Ops Center (NYOC)
[office: 212-384-2921; fax: 212-384-4073 or 4074)
Requestor Email:
Sq t ad: e--;
1) Name & Rank of Requestor.
MUST be Special Agent or other 3,
2) Name & Rank of Supervisor:
MUST be Supervisory Special Agent or of
3) Subject Name:
4) DMV Client ID # (Nine Digits):
If nn Client ID available, include Subject's D rB
role one):
ant Investigation
Witness Investigation
6) Exigent Circums ances (if applicable)*:
Comments
Ir***sh*******—Ir
--n.freevisac
e support personnel
Missing Person Investigation
7) Case number:
8) Phone number of Requestor:
The requestor acknowledges that the mquested image cannot be used as filjgg in a phot
in an any if the subject of the DMV photo is the subject in the photo array. A new request
unrelated criminal investigation. The digital image obtained will not be saved in a database
subsequent use unrelated to the original investigation.
I hereby certify that the above-requested DMV Photo Image b relevant to as a
my knowledge, the subject of interest possesses a driver's II
e, learner's permit or non
New York State DA J
and acknowledge hat I
r oat was
for an hope
ature)
Date
*When the exigent circumstances exception applies, the "Comments" section must identify the t
urgency. In addition, the "Request for DNS/ Photo Imago — Exigent Cncwmtances" form must
requesting agency.
1'
it.
Investigation and that, to the best of
;river identtlleatIon card issued
the
1 ... Me jurrpose I may be subject to
y, the OW photo may only be used
r a photo image must be made for any
stored in any manner for secondary or
/,
f investigation and explain the
pitted and retained by the
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