Page 1 of 1
of Custody-ELSUR Evidence Envelope
(Rev 847-00
513 Original
0
Magnetic Tape
Enclosure:
Medium:
Case File/:
Case Agt.:
Agt. Supervising Title III Intercepts:
O Court Authorized Intercept - Souree/Symbolti:
54
Consensual Monitoring Intercept - CM# (if assigned):
pg Telephonic (TCM) 0
Nontelephonic (NTCM)
If NTCM Specify Device Used:
O
Recording of an Interview
O Volunteered/Subpoenaed Medium - Not FBI ELSUR
O
Other Type of Recording/Interception, Specify:
Intercept Date: /0/Th .
0 CI
Place: ki
51 Pc,lin
AtA(.‘t
i FL
Data Transferred for Permanent Storage - Date: /0 a-6"/o 9
Time:
9 :apt",
O
Consensual: List Intereeptces Below
0
Court Authorized: Enter " See Log" Below
O
Duplicate
O
Computer Disk
O
Enhanced Original
O Printed Material
ID#: 1D-6
Tape/Disk#:
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Signature:
Signature:
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Time:
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Date:
Reason:
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Reason:
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Date:
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Reason:
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Reason:
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Signature
Date:
Reason:
Signature:
Signature:
Date:
Time:
Date:
Time: _
Reason:
Reason:
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