BP-AZ-3C9

BP-AZ-3C9 JAN 1, ADMINISTRATIVE DETENTION ORDER U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS TO: Sp FROM: SUBJECT Placement of EPSTEIN, JEFFREY EDWARD (Ramer ite) Reg. No. (a) Is pending an investigation for a %otation of Bureau regulations: (b) Is pending an SIS investigation. (c) Is pending investigation or trial for a cnminal act: (d) Is to be admitted to Administrative Detention (1) Since the inmate has requested admission for protection; NEW YORK MCC Inaction Date/Time- 07-29.2019 12-.21 76318-054 in Administrative Detention I hereby request placement in Administrative Detention for my own protection. Inmate SignaturelRegister No.: Staff Witness Printed Name Signature: (2) Since a serious threat exists to individual's safety as perceived by staff, although person has not requested admission; referral of the necessary information wit be forwarded for an appropriate healing by the SRO. (e) Is pending transfer or is in holdover status during transfer. (f) Is pending classificabon; or (9) Is terminating confinement In Discipimary Segregation and has been ordered Into Administrative Detention by the Warden's designee. It is this Coffectonal Supewlsor's decision based on all the circumstances that the above named Inmate's continued presence In the general population poses a serious threat lo lee. property, self, staff. other Inmates. or to the security or orderly running of the institution because' PENDING UDC FOR CODE 228 SELF-MUTILATION Therefore. the above named inmate is to be placed In Admmistratwe Detention unti further notice. The Inmate received a copy of this Order on (date/ lime) Staff Witness Signature/Printed Name Date Supervisor 24 hour review of placement: Signature/Printed name ' In the case of DHO action, reference to that order Is sufficient. In other cases, the Correctional supervisor will make an independent review and dectslen, which is documented here. Record Copy - Inmate Concerned (not necessary if placement is a result of holdover status); Copy - Captain: Copy - Unit Manager, Copy • Operation Supervisor Administrative Detention Unit Copy — Psychology. Copy - Central File PDF Prescribed by P5270 (Replaces BP-A0308 of JAN 88.) EFTA00140247