EFTA01248827.pdf

N Record Requeu ED-12S (Rev. 44 83) Date 7/7 14 / - 0-r7 • o Birth o Credit 0 Criminal 0 Death 0 INS 0 Marriage 0 Motor Vehicle 0 Other To Buded Mr we c 4.0SA-te Ca Return to File Numba 7:41." rerldieflat-er 3/e-- ann. 1° rob 2— Name and aliases ofsubject; applicant, or employee. and spouse Address Residence Business Forma • Date and place ofmarriage • (ifappl icablc) Race Sex Age Height I Weight Hair Eyes W 0 Male Birth date Birmplace a Arrest Num Fingerprint classification Criminal specialty Social Security Number Divas IicenseNumber fl (L Photo 0 Other Specific information desired 04•4(2 l•Oi . cctI1 Ako.....,:d/i/m4 71,..,I 0 i_ P4.t4 Results dank • MM01-VICTIMS 1-7 BINDER-000152 3501.222-022 CONFIDENTIAL Page I of I EFTA_00075009 EFTA01248827