U.S Department of Justice

U.S Department of Justice United States Marshals Service FEDERAL PRISONER'S PROPERTY RECEIPT (Inanacitons on Reverse) ITEMS RECEIVED: NO PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY NO OPERTY NO PROPERTY P NO PROPER P NO PROPER P TY NO PROPERTY TV NO PROPERTY PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY . • • NO PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY NO PROPERTY CELLBLOCK INMATE NAME. INMATE SIGNATURE: MDC BROOKLYN Original (White) - To Committing Officer Duplicate (Yellow) • To Jena - Triplicate (Blue).- To Prisoner Quadruplicate (White) • Extra FORM US A I• IS (Rev CBS) Automated OM' EFTA00106173 LAW ENFORCEMENT SENSITIVE. i Criminal History (Stied from dropdown menu or Ore offense below) Arrest (d) Conviction On j Remarks e.g.. name of gang or criminal organization, etc.): Pr. ID Money Launderer ID Kingpin K Violent Offen