Case 1:17-mj-00024-BKE Document 12 Filed 06/06/17 Page 1 of 3

A093 (Rev I  /I3) Search and Seiziifo Wanani(Pagel)
Return

Case No,:

Date and time warrant executed:

Copy of warrant and inventory let\ with:

ftr ggsti^cg
Inventory made in the presence of:

^AUTY

Ql,JAl£fg

Inventory of the property taken and name ofany person(s) seized:

5ee: A'rrAcHey>

Certification

i declare tinder penalty of perjury that this inventory is correct and was returned along with the original warrant to the
designated Judge.

Date:

A'.trcuwix officer i iigmiliire

'^osTiu C.<^^ctc.
I'nnlei/ nume anil nik-

 Case 1:17-mj-00024-BKE Document 12 Filed 06/06/17 Page 2 of 3
Page

rD-597 {Rev 8-11-94)

of

UNITED STATES DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF INVESTIGATION

Receipt for Property Received/Returned/Released/Seized
File #

item(s) listed below were:

On (date)

0 Received From
Q Returned To
Q R^eased To

Q-^zed

(Name)

(Street Address)_ ;i<7 Rjj.
(Citv)

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Description of Item(s): L
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11

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—'

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Received From:

Received By:

--(Signature)

ElZTrv:
(Signature)

 FD-597 (Rev 8-11-94)

Case 1:17-mj-00024-BKE Document 12 Filed 06/06/17 Page
3
9Page3 of

of

UNITED STATES DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF INVESTIGATION

Receipt for Properly Reccived/Returned/Released/Seized
File #

On (date)

 

item(s) listed below were:

Q Received From
Q Returned To
Q Released To
[g--Smzed

(Name)

€/~

(Street Address)
(City).

Description of Item(s):

Received From:

Received By:
'(Signature)

(Signature)