Evidence Control Form
PDF, 1 page from the NTSB's investigation of the Piper PA-28R-201T accident near Holdrege, Nebraska, July 19, 2013. Shown as the NTSB released it (fetched from the NTSB as you open it).
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About this document
It is item 2 in the NTSB's docket for case CEN13FA429, titled "Evidence Control Form" by the NTSB, 1 page. The NTSB removes some personal details before releasing docket documents; this site shows them as released and does not alter them. The docket at the NTSB.