13P.AnCia¶
JAN 17¶
ADMINISTRATIVE DETENTION ORDER U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS¶
| NEW YORK MCC | ||||
|---|---|---|---|---|
| instsition | ||||
| Date/Time- 07-29.2019 12.21 - | ||||
| ng Unit Officer TO: Special H | ||||
| FROM: | (Name/rite) | |||
| SUBJECT: Placement of | EPSTEIN. JEFFREY EDWARD | Reg. No. | 76318-054 | in Administrative Detention |
| (a) Is pending an investigation for a vrolation 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; | ||||
| I hereby request placement in Administrative Detention for my own protection. | ||||
| Inmate Signature/Register No.: | ||||
| Staff Witness Printed Name Signature: | ||||
| the necessary information wit be forwarded for an appropriate hearing by the SRO. | (2) Since a serious threat exists to individual’s safety as perceived by staff, although person has not requested admission; referral of | |||
| (e) | Is pending transferor is in holdover status during transfer | |||
| (f) is pending classificatory or | ||||
| Is terminating confinement In Disciplinary Segregation and has been ordered Into Administrative Detention by the Warden’s (9) designee. | ||||
| population poses a serious throat lo !de. property, self, staff, other inmates. or to the security or orderly running of the institution because’ | II is the Correctional SupenAsor’s decision based on all the circumstances that the above named Inmate’s continued presence in the general | |||
| PENDING UDC FOR CODE 228 SELF-MUTILATION | ||||
| Therefore, the above named Inmate is to be placed in Administrative Detention unti further notice. The Inmate received a copy of this Order on | ||||
| (date / time) | ||||
| Staff Witness Signature/Printed Name | Date | |||
| Supervisor 24 hour review of placement: Signature/Printed name | ||||
| documented here. | • In the case of DHO action, reference to that order is sufficient. In other cases, the Correctional supervisor will make an independent review and decision. which I | |||
| Administrative Detention Unit; Copy — Psychology. Copy - Central Fib | Record Copy - Inmate Concerned (not necessary if placement is a result of holdover status); Copy - Captain: Copy - Unit Manager, Copy • Operation Supervisor | |||
| Prescribed by P5270 | (Replaces BP-A0308 of JAN 88.) |
EFTA00035216¶