EFTA00005774

Nys c 22r Atann .5SAL' a um ve.4 y . Aimecss- e7y) /A17/ Ns 1- 117‘ at-f- EFTA00005774 DMV Photo Subject Information Name: ClientiD: Case Number: SI DMV Transaction Number: 1069006 DMV Transaction Date/Time: 2019-06-05 18:36:18:690 EFTA00005775 Last updated: 01108/2017 Request for NYS DMV P OTO IMAGE To: New York Ops Center (NYOC) [office: 212-384-2921;fax: 212-384-4073 or 4074) Requestor Email: Sq t ad: e--; Ir***sh*******—Ir 1) Name & Rank of Requestor. MUST be Special Agent or other 3, 2) Name & Rank of Supervisor: MUST be Supervisory Special Agent or of --n.freevisac e support personnel 3) Subject Name: 4) DMV Client ID # (Nine Digits): If nn Client ID available, include Subject's D rB role one): ant Investigation Witness Investigation Missing Person Investigation 6) Exigent Circums ances (if applicable)*: Comments 7) Case number: 8) Phone number of Requestor: The requestor acknowledges that the mquested image cannot be used as filjgg in a phot 1'y, the OW photo may only be used in an any if the subject of the DMV photo is the subject in the photo array. A new request it. r a photo image must be made for any unrelated criminal investigation. The digital image obtained will not be saved in a database stored in any manner for secondary or subsequent use unrelated to the original investigation. I hereby certify that the above-requested DMV Photo Image b relevant to as a Investigation and that, to the best of my knowledge, the subject of interest possesses a driver's II e, learner's permit or non ;river identtlleatIon card issued the New York State DA J and acknowledge hat I r oat was for an hope 1 ... Me jurrpose I may be subject to /, ature) Date *When the exigent circumstances exception applies, the "Comments" section must identify the t f investigation and explain the urgency. In addition, the "Request for DNS/ Photo Imago — Exigent Cncwmtances" form must pitted and retained by the requesting agency. EFTA00005776 EFTA00005777 EFTA00005778 EFTA00005779 EFTA00005780 EFTA00005781 EFTA00005782