EFTA00109590¶
U.S. DEPARTMENT OF JUSTICE¶
ARRESTERING WILL COMPUTE PERSONAL REQUIRED DAYTON HAS FORM BRIDGE TO CORNWICH.¶
| Name: Last | First | Middle |
|---|---|---|
| AKAs: |
RACE (Check)¶
- B W A I
- M W I
CHANGES CHECK CATEGORY OF CHARGES(S):¶
- FELONY
- USC:
- NARRATIVE:
- NARRIVE VE:
- Title:
CHANGES CHECK CATEGORY OF CHARGES(S):¶
- MISDPEMANOR
- CIVIL CONTEMPT
- MATERIAL WITNESS OTHER
DATE OF OFFENSE: Date of Arrest: Place of Arrest:¶
State of Birth¶
- Country of Birth
- Citizenship
Height In:¶
- Weight
- Hair
- Eyes
Scars / Marks / Tattoos¶
Injuries / Medication¶
Arraigned Y N¶
- Sentenced Y N
- Remarks:
IN¶
- IN
- IN
Remanding Official Sign¶
- name
- Agency/District
Print¶
- OUT
- OUT
Removing Official (Name) Sign¶
- name
- Agency/District
Print¶
FOR BOP USE ONLY¶
Receiving Official (Name) Sign¶
- Date / Time
- Receiving Official (Name) Sign
- Date / Time
Sentry Load Data (Must Initial)¶
- Name Search Completed by:
- Clearance/Separate Checked by:
(OPTIONAL USE)¶
- Staff Init.
- Add ARVs
- Create Cash Account
- Delete Fash
- Detailer
- Clothing Bag #
RIGHT THUMBPRINT¶
Original-for ISM as Remanding-Removal receipt Copy-for Control as Removal Receipt (NCIC); Copy-For Removing Official; Copy-for Control as Remanding Receipt (Immediate); Copy-INS-Alien in Custody.¶
This form may be replicated via NP)¶
BP-5771.058 PRISONER REMAND CUFMU TP-34 FEDERAL BUREAU OF PRISONS¶
Releasing Sign Print¶