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SECRET CLASSIFIED BY: NSICG J76J18T80 ASON1.4C DECLASSIFY ON: 12-31-2041 DATE: 11-21-2016 ALL INFCRMATION CONTAINED HEREIN IS UNCLASSIFIEL EXCEPT WHERE SHCWN OTHERWISE 1A 5Z FD-340(Rev. 4-1t- b3 File Number b7E 59 Serial # of Originating Document 2/1s/zo\) Date Received From (Name of Coniributor/Intcrviewee) (Address) (City and State) b6 b7C To Be Retumed Yes Yes No Receipt Given Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) Federal Rules of Criminal Procedure Yes Yno Federal Taxpayer Information (FTI) Yes b1 1S! b3 b7E M2s#AN dLING of CLAssIFIeD Reference: (Communication Enclosing Material) b6 b7C HRC-1439