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FEB-14-1 20:49 FRON avannah Info Center TO $011441714997944 P.04 F809(R.125-9) 90797 IC Use Only: Srtc Record #: NVESTIGATIVE INFORMATION REQUEST FORM Date/Timc In: 41/223 Ompm De am p FBI, Savannah Information Technology Center psn(ssegng 20 East Bryax Sureet $. Savawnah, Georgia 31401 2. NC 6. 10. b6 > Commercial ) rciephone or FTS: (912) 944-0824 thru 0828 3.. 11. b7C FAX:91231-1076and9122310974 4. 1 b7E > Secure FAX STU III: (912) 231-1075 Handlod By: TO: FBI, SAY ANNAH INFORMATION TECHNOLOGY CENTER FF7 6-b 3fr-1L1-pt-}lO Date: Z1197 b6 Forfeiture/S izure Related: Type of Request: (3 FAX TeIcaI Mail Response: Telcai Mail b7C b3 Requestor Phone #:, FAX #: UCEN: Fb7E Precedence: Office/RA: ROUTINE (Emergency/Cnsis Situation) SEARCH C RITERIA (Attach additional sheets if necessary) Parent Faice Name - Last: First: Middle: Sex: DOBI: Alias: 1 L41_DOB2: F 142 SSAN1: 11 SSAN2: Spouse: Fugitive: Yes No Driver's License #: State:. RESIDENC Street Address: City/State: Zip: Phone: BUSINESS Business Nape: Street Address: City/State: Zip: Phone: Business ID#: CHECK DESIRED SEARCH PARAMETERS (PIease check only those that are needed) 1. Specific Information Desired NCXC Bevenn MsGowas (yistin) 2. Determine All Individuals Associated with Social Security Number($) 3. Report[Validity of Social Security Number 4. Deterujine Who is Associated with Telephone Number(s) 5. Detetu ine Address of Business/Person ( U.S. State(s)) 6. Detern ine Property Owned by Individual ( _U.S. State(s)) 7. Deterr ine Who Owns Property Listed Above 8. Deternjine Who Resides at Address Listed Aboye 9. Determine Financial Background Info, i.c., Bankruptcy, Judgments, Liens, UCC filings, or Lawsuits. 10. Determine Corporate Business Info, i.e., Officer, Diector, Registered Agent. (Person/Business) 11. Customs Border Crossings / Subject query / I-94 iofo(circle one) 12. Federal Prison Inmate Ioformation 13. Telenlarketing Complaints Reply From: FBI, Savannah Information Technology Center (SITC) Retum Reply To: heoot Sac. hondan Atteation:, b6 Based . Jxtd records are atached: b7C Possible Identifiable Records Brief Synopsis of Information Found Other Peripheral Joformation No Ioformation Found