### LAW ENFORCEMENT SENSITIVE ### U.S. Department of Justice United States Marshals Service | | United States Marshals Service | | Personal History of Defendant | |-------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------| | Taken into Federal custody by the following: | Street Arrest (not from a correctional/detention facility)
Custodial Arrest (from a correctional/detention facility) | | Trit Used (Must provide copy of writ)
Prior Federal Arrest or Safekeeper - Register = | | BIOGRAPHICAL INFORMATIO | | Safekeeper Location: | | | Last Name: | | First Name: | Middle Name: | | Sex: | Transgender | Pregnant: | Race: | | Hair: | | Height: | Weight:
DOF | | City of Birth: | | State/Country of Birth: | Citizenship: | | FBI # | State ID#: | Alien #: | ટેટે | | Resident Address/City/State/ZIP: 4 | | | | | Home Phone: | | Cell Phon | Marital Status: | | COURT CASE | | | | | Agency: | | | Agency ORI: | | Agent Last Name: | | First Name: | | | Agent Phone #: | | | Arrest Date: | | Location/Facility of Arrest: | | | | | Court Docket #: | ( R | SA(S) Assigned | | | OFFENSE | | | | | NCIC Code | Charge Description | | | | | | | | | Known Detainers/Warrants: | | | (Must provide a copy of any detainers) | | | | | | | | | | | | | | Long Term Medical Conditions (e.g., heart problems, diabetes, asthma, tuberculasis, IIIV. AIDS, hepatiis. etc.); | | | | | Psychiatric/Emotionally Disturbed (e.g., mental health concerns, suicidal, etc.): | | | Injuries/Medical Ailments/Post-Op Recovery: | | | | | Do the above conditions require: | | | | | Medical attention? | | | | | Medication? | | | | | Medical clearance by a licensed physician: | | | | | Is Defendant under the influence of drugs or alcohol: | | 01
AN | | | Languages - English:
Other Language: | · 1.151: | Limited | | | CALTIONS AND MEDICAL
Security Cautions: | | | | ULES Page 1 of 3 Form USM-312 Rev. 11/17 ### LAW ENFORCEMENT SENSFITIVE Remarks: | ALTASES | | | | | | | | | | | | | |-----------------|----------------------------------------------------------------------|-----------|------------------------------------------------|-----------|------------------------------|-----------|------------------------|---------|----------------|------------------------------------------------|------------------------|------------------------| | ALIAS Last Name | | | ALIAS First, MI | | Remark | | | | Date of Birth | ટેટેટી | | State Driver's License | | | | | | | | | | | | | | | | | ASSOCIATES / CO-DEFENDANTS / RELATIVES / CHILDREN / SIGNEICANT OTHER | | | | | | | | | | | | | | | | | | | | | | | Resident Address, City, State. | | | | Relationship | | Last Name | | First, MI | | | Register # | | ZIP Code | | | Phone | | | | | | | | | | | | | | | | MARKS | | | | | | | | | | 2224 724 | | | | | Scar/Mark/Tattoo (Specify) | | Location | | | | Description | | | | | | | 16
N | | | | | | | | | | | | | | VEHICLES | | | | | | | | | | | | | | Vehicle | | | | | | | | | State and | Registration | | | | Sear | Make | Model | | ('olor(s) | | | Vehicle Style | Plate # | | Date | 1.12 | | | LICENSES | | | | | | | | | | | | | | License Number | | | License State | | | | | | | | | | | | | | | | | | | | | | | | | | MISCELLANEOLS ALMBERS | | | | | | | | | | | | | | | | | | | | | | | | | | | | Miscellaneous Number | | Type (Select from dropdown menu or type below) | | | | | | | Remarks (e.g., Issuing State or Country, etc.) | | | | OCCUPATIONS | | | | | | | | | | | | | | Occupation: | | 5201 | | | | | | | | | | | | | | | | | | | Company/Employer Name: | | | Southern | | | | | Employment Address: VIRE | | | | | ANO | | | | Phone | | | | Start Date: | | | End Date: | | | | Point of Contact: | | | | | | | FINANCIAL | | | | | | | | | | | | | | Bank Name | | | Account Type | | | Account # | | | Branch Address | | | Phone # | | | | | | | | | | | | | | | | MILLIARY | | | | | | | | | | | | | | | Rank | | Entry
Date | | Discharge
Date | | Discharge Type | | | Military Occupation | Remarks | | | | | | | | | | | | | | | | | REMARKS | | | | | | | | | | | | | | | Additional Information/Remarks/Continuation: | | | | | | | | | | | | | | | | | | | | | | | | | | | PROFILE | | | | | | | | | | | | | | | Defendant Risks: * Requires remarks below | | | | | | | | Sex Offender: | | | | | Escapee | | | Planned Murder | | | | | Arrest | | Conviction | | | | | Organized Crime* | | Protected Witness | | | | | | Registered | | Registration Violation | | | | International Terrorist | | Domestic Terrorist | | | | | | | | | | | Gang Member * | | | | | Significant Criminal History | | | | | | | | | | Multiple Defendants | | Death Penalty Case | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Rev. 11/17 일 ### LAW ENFORCIiNIENT smrovii | Criminal History Mira front dropdmen
menu IV ON offense below) | | Arrest (H) | Conviction (II) | | | |-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--|--| | | | | | | | | (e.g.,
Remarks
name of gang or criminal organization, etc.): | | | | | | | Pr
Money Launderer
0
Violent Offender | | | | | | | ❑ Kingpin
IN I l'RNI I 14/.OI to I | | | | | | | Internet Source | | | | | | | }Remarks (e.g., email address, | website address, usernamc. etc.) | | | | | | NOTICE TO ARRESTING AGENTS:
As a courtesy. the USMS may temporarily hold
personnel in the cellblock until the arresting agent(s)
Magistrate. A prisoner remains the responsibility
of the arresting agency until remanded
When a courtesy hold is allowed
by the USMS to be housed in a USMS
agency must be available to respond to the cellbloci.
the arresting agency refuses
to comply with USMS procedures. the courtesy hold
USMS. and remain the responsibility | in order to address any issues with their | make arrangements for the prisoner's initial
cellblock, a minimum of one agent from | an arrestee received by non-USSIS
appearance before a United States
to the custody of the USMS by the coons.
the arresting
prisoner (e.g medical. discipliner) I. If
may be refused. Meals arc not provided by the | | | | of the arresting agent(s).
ARRESTEE PROCESSING
CHECKLIST
For Arresting Officer Only | | A RRESTEE PRO( 'ES.SING
For ISMS Personnel Only | | | | | 4USM
-3I2 (Personal Ilium- of Defendant)
Medical clearance (from licensed
physician). if ncvcssar) | Confinn all arresting agent documentation
is completed and
•
inserted into prisoner's file | | | | | | 'op) of Arrest Warrant, if issued | USNI-3 12 (Personal History of I kfctidant)
•
coke c./.
signedunr/dm/hyhmate frl St/ l)&) | | | | | | Copy of C'omplaint. Information.
or Indictment. if completed
CI Copy of Detaincifik
if issued | t SM-552 (Prisoner Medical Records Release
•
Form I -
convicted
vignetiond
dam/
by
intuit.' 1 N Nil DEO | | | | | | r'opy of Writ, if applicable
El Correctional facility discharge | O I %M-18 (Federal Prisoner Properly
Receipt) • edonp/cre.f.
signer/um/ glared by inbtke h1 511 DEO | | | | | | papers. if applicable
Correctional facility prisoner
receipt. if applicable | ❑ USNI—I0/4I (Prisoner Remand) - inverted
ima prisoner:vide | | | | | | Correctional facility medical
summary. if applicable | VSM-I30 (Prisoner Custody Alen Notice).
if applicable -
• | | | | | | Prepared By - Name:
ilf110
ivy
riS-4
Agency:
"-
Cell Pinot
Date: af
)
://f | inserted imo /rLYolk'r Ties'
ED•249 (Fingerprint Card) - primer/and inserted
boo
•
pristinetit file
O
Prisoner Photograph ( from Booking Package)
- priorredind | | | | | | | | inserted jilts' prkillkt
.A /lie | | | | | | | | | | | | | Reviewed By: | | | | | lU LES Page 3 of 3