BP-S377.050 PRISONER REMAND

BP-S377.050 PRISONER REMAND FEB 04 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS ARRESTING OFFICER WILL COMPLETE LL 'REQUIRED DATA ON THIS FORM PRIOR TO COMMI /NG TO:, ' MCC/MDCs. Register Number Name: Las: MiddUe AKAs: Race (Check) B IM A I Sex (Check) F Ethnic Origin (Check) _Hispanic on Other D.O.B. SSN: CHARGES CHECK CATEGORY OF CHARGES(S): FELONY MISDEMEANOR CIVIL CONTEMPT MATERIAL WITNESS ... OTHER NARRATIVE: Title: USC: NARRATIVE7-- Title: USC: 1 am•••••."' : i • „ V PJ Date of Offense: Date of Arrest: Place of Arrest: or. ' State of Birth Country.of Birth Citizenship . Current Address Zip Code :. Height Ft: In: Weight Hair. Eyes. Scars / Marks / Tattoos Injuries / Medication Emergency Contest:-(Name,- Address, Phone Number) Arraigned Y N Sentenced —_ Y __ N Special Handling: Y or N Remarks: NVIPRm Remanding Official (Name) I Agency/District Sign Print Phone/24 Hour Number Sign. Print (:';grn,Y) Receiving Official (Name) Sign Print Date / Time Releasing,Official. (Name) Sign ,. . a Print Cate / Time y/District ?hone/24 Hour Number Sentry Load Data: (Must Initial) Name Search Completed by: Clearance/Separate Checked by: (OPTION ARS Code Add AKA' Create Cash Account Deposit Cash Amt. Detainers Court Clothing Bag 4 Staff Init. RIGHT THUm PRINT Original-for ISM -as Remanding-Removal receipt; Copy-for Control as Removal-Receipt (NCIC)it)Copy-For Removing Official; Copy-for Control as Remanding Receipt (Inmate); Copy-INS-Alien in Custody. (This form may be replicated via WP) This form replaces BP-Sir/mat mnA Ors.,'”ora. EFTA00109695