Coast Guard Investigative Service Evidence Custody Form Page 2

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19. CHAIN OF CUSTODY (CONT'D)

Date/Time

Items

Released By

Received By

Purpose

Name

Organization

Signature

Name

Organization

Signature

Name

Organization

Signature

Name

Organization

Signature

Name

Organization

Signature

Name

Organization

Signature

Name

Organization

Signature

20. FINAL DISPOSITION

Final Disposition Authority

Organization

Name (Printed)

Grade/Rank

Persons Witnessing Destruction (Print)

Organization

Signature and Date

NOTE: You MUST indicate in Disposal Action Column (on front) by two number or letter code, persons receiving or witnessing action and the type of action.

CODES: (R) Person receiving

(W) Witness to Action

(A) Turned over to another Agency

(1) Returned to Individual Owner

(S) Turned into Supply

(D) Destroyed

(M) Another method (explain in Remarks section)

EXAMPLE:

Code R1 = person receiving the item was the owner;

WD = person witnessed the destruction of the item;

RC = person receiving item returned it to the command

21. REMARKS