DOJ-OGR-00028957.pdf

--- Page 1 --- **Document Extraction** **Header Section:** * **FD-794 (Rev. 2-7-00)** **Classification:** * **AQ) Criminal Case** * **AO) General OCDETF Case** * **AF) FCI Case** * **ac) Informant/CW** * **ad) Informant/CW Providing Drug Info.** * **CF) Asset** * **DD) Group II UCO** * **QC) OCDETF Group II** * **SG) SG AF Operation** * **TH) SSG** * **GA) SOG** * **J) FCI Lookout** **Draft Request:** * **Request for:** [ ] Advance [ ] Expense * **Payee Name:** [ ] * **Cat Item No:** [ ] * **Cat:** [ ] * **Item No:** [ ] * **Description:** [ ] * **Amount:** [ ] **9. Total $** * **10. Justification:** * **Asset/Informant File No.:** [ ] * **Payment/Code Name:** [ ] * **One Time Non-symbol Source Payment:** [ ] * **True Name:** [ ] * **Date of Waiver:** [ ] * **11. Payment for reimbursable expense - forfeiture or drug related?:** [ ] Yes [ ] No * **12. Requested by:** [ ] * **13. Telephone No.:** [ ] * **14. Approval** * **Supervisor Initials:** [ ] * **SAC/ASAC/AO/SAS Approval:** [ ] * **Supply Technician Approval:** [ ] * **Draft Approval Officer:** [ ] * **Procurement Authorization:** [ ] * **15. Vendor No.:** [ ] * **Group No.:** [ ] * **16. Date:** [ ] * **17. Obligation No.:** [ ] * **18. Cost Center:** [ ] * **19. Squad/RA:** [ ] * **20. Follow-up Date:** [ ] * **21. Document No.:** [ ] * **22. CONF:** [ ] * **23. Draft No.:** [ ] * **24. Date:** [ ] * **25. Cashier:** [ ] * **26. Settlement of Advance:** [ ] * **This Advance:** [ ] * **Less Receipts:** [ ] * **Funds Returned and/or Cash on Hand:** [ ] * **Amount to be Reimbursed:** [ ] * **27. Document No.:** [ ] * **28. Draft No.:** [ ] * **29. Date:** [ ] **Classification:** * **Classified By:** [ ] * **Declassify On:** [ ] **Blue Copy - Administrative/Case File** **Shaded areas for draft office use only** **31C-MM-118062-69** **DOJ-OGR-00028957**