NO NYS OR II HISTORY
VIA E-Justice

Cell
NORDST

POSSIBLE SOCUSE

Same Address

SSN:

ADDRESS:

Sleepy Hollow NY
(Westchoton сту 10591

NYS DIL ADDRAMS AS:





## DMV Photo

<table><tr><th colspan="2">Subject Information</th></tr><tr><td>Name:</td><td></td></tr><tr><td>ClientID:</td><td></td></tr><tr><td>Case Number:</td><td>SI</td></tr><tr><td>DMV Transaction Number:</td><td>1069006</td></tr><tr><td>DMV Transaction Date/Time:</td><td>2019-06-05 18:36:18:690</td></tr></table>



Last updated: 01/08/2017

# Request for NYS DMV PHOTO IMAGE

To: New York Ops Center (NYOC)
[office: 212-384-2921; fax: 212-384-4073 or 4074]

- Requestor Email:

@fbi.sgov.gov Squad:

C-20

*************************

***************

1) Name & Rank of Requestor: TEO MUST be Special Agent or other sworn law emo:content – may not be support personnel

2) Name & Rank of Supervisor: LT TFO supervisor MUST be Supervisory Special Agent or other sworn law enforcement-may not be support personnel

3) Subject Name:

4) DMV Client ID # (Nine Digits): If no Client ID available, include Subject's DOB

	5) Reason for request (Circle one):

		- Criminal Investigation Warrant Investigation

Witness Investigation

Missing Person Investigation
# Request for NYS DMV PHOTO IMAGE (cont.)

6) Exigent Circumstances (if applicable)*:

	- Comments

7) Case number:

31E-NY-3027571

8) Phone number of Requestor:

The requestor acknowledges that the requested image cannot be used as filler in a photo array; the DMV photo may only be used in an array if the subject of the DMV photo is the subject in the photo array. A new request for a photo image must be made for any unrelated criminal investigation. The digital image obtained will not be saved in a database or stored in any manner for secondary or subsequent use unrelated to the original investigation.

I hereby certify that the above-requested DMV Photo Image is relevant to an active investigation and that, to the best of my knowledge, the subject of interest possesses a driver's license, learner's permit or non-driver identification card issued by the New York State DM and acknowledge that if this request was made for an impermissible purpose I may be subject to

Requestor (Signature Date

Supervisor (Signature) Date

*When the exigent circumstances exception applies, the "Comments" section must identify the type of investigation and explain the urgency. In addition, the "Request for DMV Photo Image - Exigent Circumstances" form must be completed and retained by the requesting agency.
# Request for NYS DMV PHOTO IMAGE (cont.)