Control No.

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FORM B (Rule 6)

CERTIFICATE OF PROOF OF

CHAIN OF PHYSICAL CUSTODY OR CONTROL

(Initial Custody)

This is to certify that I, , am employed by and that on, , I seized from pursuant to at or near the following substance(s) or container(s):

(Describe substance or container with sufficient particularity to distinguish it.)

On , I made delivery of the above described substance(s) or container(s) to of in substantially the same condition as when I received it.

(Signature)

(Place):

(Date):

Sworn before me this	)
day of	,	2 .	)
)
)
Notary Public for South Carolina	)
)
My Commission expires	)

Control No

cyon

2003-02-26

South Carolina Judicial Department