EFTA00005774.pdf

Type: pdf
Source set: data-set-4
Extracted text

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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--; 
1) Name & Rank of Requestor. 
MUST be Special Agent or other 3, 
2) Name & Rank of Supervisor: 
MUST be Supervisory Special Agent or of 
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 
6) Exigent Circums ances (if applicable)*: 
Comments 
Ir***sh*******—Ir 
--n.freevisac 
e support personnel 
Missing Person Investigation 
7) Case number: 
8) Phone number of Requestor: 
The requestor acknowledges that the mquested image cannot be used as filjgg in a phot 
in an any if the subject of the DMV photo is the subject in the photo array. A new request 
unrelated criminal investigation. The digital image obtained will not be saved in a database 
subsequent use unrelated to the original investigation. 
I hereby certify that the above-requested DMV Photo Image b relevant to as a 
my knowledge, the subject of interest possesses a driver's II 
e, learner's permit or non 
New York State DA J 
and acknowledge hat I 
r oat was 
for an hope 
ature) 
Date 
*When the exigent circumstances exception applies, the "Comments" section must identify the t 
urgency. In addition, the "Request for DNS/ Photo Imago — Exigent Cncwmtances" form must 
requesting agency. 
1' 
it. 
Investigation and that, to the best of 
;river identtlleatIon card issued
 the 
1 ... Me jurrpose I may be subject to 
y, the OW photo may only be used 
r a photo image must be made for any 
stored in any manner for secondary or 
/,
f investigation and explain the 
pitted and retai…
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