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VOLUNTARY STATEMENT

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I have read each page of this statement consisting of 2 page(s), each 
any, bears my nitials, and [certify that the facts contain

Date: 0

 

 

 

 

 

 

 
  
      
   
    

age of which bears my signature, and corre 

 
 

ed herein are true and

  

  

I certify that I have been given a copy 0

   

ystatement consisting of pages.

Form CF-002 (Rev. 7-24-06)
CALEA 1.2.3, 44.2.3

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CFOOS 5/95 VOLUNTARY STATEMENT

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Person giving statement to place initials behind
last word of statement as appears on iast page.