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FD-340 (Rev.4-11-03 File Number Mm 1PBcRA Field Office Acquiring Evidence - Serial # of Originating Document 04/t/68 Date Rereived b6 -3 From b7C -3 (Name of Contributor/Interviewee) b3 -1 (Address) Cin and State) b6 -2 j b7C -2 To Be Retumed Yes 4XNo Yes ANO Receipt Given Grand Jury Material - Disseminate Oaly Pursuant to Rule 6 (e) Federal Rules of Criminai Procedure, oN X Federal Taxpayer Information (FTI) sA Title: Reference: (Conmunication Enclosing Material) 1 Description: Onginal notes re interview-of .... ot kephone# b6 -3 b7C -3 b3 -1 03956-8147