Part 88, page 34

Transcript

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FEDERAL BUREAU OF INVESTIGATION, UNITED STATES DEPARTMENT OF JUSTICE WASHINGTON, D. C. 20537

PALM PRINTS TAKEN? YES [ ] NO [ ] PHOTO AVAILABLE? YES [ ] NO [ ]

IF AVAILABLE, PASTE PHOTO OVER INSTRUCTIONS IN DOTTED AREA. ___________ (DO NOT USE STAPLES) SINCE PHOTOGRAPH MAY BECOME DETACHED INDICATE NAME, DATE TAKEN, FBI NUMBER, CONTRIBUTOR AND ARREST NUMBER ON REVERSE SIDE, WHETHER ATTACHED TO FINGERPRINT CARD OR SUBMITTED LATER.

IF ARREST FINGERPRINTS SENT FBI PREVIOUSLY AND FBI NO. UNKNOWN, FURNISH ARREST NO. _________ DATE _________

STATUTE CITATION (SEE INSTRUCTION NO. 9) CIT 1. 2. 3.

ARREST DISPOSITION (SEE INSTRUCTION NO. 5) ADN

EMPLOYER: IF U. S. GOVERNMENT, INDICATE SPECIFIC AGENCY. IF MILITARY, LIST BRANCH OF SERVICE AND SERIAL NO.

OCCUPATION

RESIDENCE OF PERSON FINGERPRINTED

SCARS, MARKS, TATTOOS, AND AMPUTATIONS SMT

BASIS FOR CAUTION ICO

DATE OF OFFENSE DOO SKIN TONE SKN

MISC. NO. MNU

ADDITIONAL INFORMATION

164-704-1A(2)

FD-249 (REV. 3-13-72) ☆ GPO: 1974 — 559-701

--- INSTRUCTIONS (right column) ---

1. UNLESS OTHERWISE PROVIDED BY REGULATION IN YOUR STATE, FINGERPRINTS ARE TO BE SUBMITTED DIRECTLY TO FBI IDENTIFICATION DIVISION. FORWARD IM- MEDIATELY FOR MOST EFFECTIVE SERVICE.

2. FINGERPRINTS SHOULD BE SUBMITTED BY ARRESTING AGENCY ONLY MULTIPLE PRINTS ON SAME CHARGE SHOULD NOT BE SUBMITTED BY OTHER AGENCIES SUCH AS JAILS, RECEIVING AGENCIES, ETC.). REQUEST COPIES OF FBI IDENTIFICATION REC- ORD FOR ALL OTHER INTERESTED AGENCIES IN BLOCK BELOW. GIVE COMPLETE MAILING ADDRESS, INCLUDING ZIP CODE.

3. TYPE OR PRINT ALL INFORMATION.

4. NOTE AMPUTATIONS IN PROPER FINGER BLOCKS.

5. LIST FINAL DISPOSITION IN BLOCK ON FRONT SIDE. IF NOT NOW AVAILABLE, SUB- MIT LATER ON FBI FORM R-84 FOR COMPLETION OF RECORD. IF FINAL DISPOSI- TION NOT AVAILABLE SHOW PRE-TRIAL OR ARRESTING AGENCY DISPOSITION, e. g., RELEASED, NO FORMAL CHARGE, BAIL, TURNED OVER TO, IN THE ARREST DISPOSI- TION BLOCK PROVIDED ON THIS SIDE.

6. MAKE CERTAIN ALL IMPRESSIONS ARE LEGIBLE, FULLY ROLLED AND CLASSIFIABLE.

7. CAUTION - CHECK BOX ON FRONT IF CAUTION STATEMENT INDICATED. BASIS FOR CAUTION (ICO) MUST GIVE REASON FOR CAUTION, e. g., ARMED AND DANGEROUS, SUICIDAL, ETC.

8. MISCELLANEOUS NUMBER (MNU) - SHOULD INCLUDE SUCH NUMBERS AS MILITARY SERVICE, PASSPORT AND/OR VETERANS ADMINISTRATION (IDENTIFY TYPE OF NUM- BER).

9. PROVIDE STATUTE CITATION, IDENTIFYING SPECIFIC STATUTE (example - PL [illegible] PENAL LAW) AND CRIMINAL CODE CITATION INCLUDING ANY SUB-SECTIONS.

10. ALL INFORMATION REQUESTED IS ESSENTIAL.

SEND COPY TO:

REPLY DESIRED? YES [ ] NO [ ] (REPLY WILL BE SENT IN ALL CASES IF SUBJECT FOUND TO BE WANTED)

IF COLLECT WIRE OR COLLECT TELEPHONE REPLY DESIRED, INDICATE HERE: (WIRE SENT ON ALL UNKNOWN DECEASED) WIRE REPLY [ ] TELEPHONE REPLY [ ] TELEPHONE NO. AND AREA CODE ___

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