Record

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¶