EFTA00109622

BP-S377.058 PRISONER REMAND CDFRM

U.S. DEPARTMENT OF JUSTICE

FEDERAL BUREAU OF PRISONS

# ARRESTING OFFICER WILL COMPLETE ALL REQUIRED DATA ON THIS FORM PRIOR TO COMMITTING TO MEC/WEDS.

| Name: Last ___ | First ___ | Patrick | Register Number 79817-0511 | PICTURE TURE |
| :--- | :--- | :--- | :--- | :--- |
| AKAs: | | | | |

**Race (Check)**
- B XW A I

**Sex (Check)**
- XM F

**Ethnic Origin (Check)**
- Hispanic or Other

**D.O.B.**
SSN:

**FBI:** 5620237
**INS:** Other:

**CHARGES**
- CHECK CATEGORY OF CHARGES(S):
- FELONY
- MISDEMEANOR
- CIVIL CONTEMPT
- MATERIAL WITNESS
- OTHER

**NARRATIVE:**
Title: ___
NARRATIVE: Title: ___
USC: ___

**Date of Offense:** 08/01/2019 **Date of Arrest:** 08/01/2019 **Place of Arrest:** Street

| State of Birth Texas | Country of Birth U.S. | Citizenship U.S. | Current Address | Pin Code |
| :--- | :--- | :--- | :--- | :--- |
| Height Ft: 5 In: | Weight 21.5 | Hair Brown | Eyes Brown | Scars / Marks / Tattoos |

**Injuries / Medication**

Emergency Contact: (Name, Address, Phone Number)

| Arraigned Y N | Sentenced Y N | Special Handling: Y or N Remarks: |
| :--- | :--- | :--- |
| IN | IN | IN | IN |

**Remanding Official (Name) Sign Print**

Agency/District Phone/24 Hour Number

612) 331-7070

**OUT OUT OUT**

**Removing Official (Name) Sign Print**

Agency/District Phone/24 Hour Number

---

## FOR BOP USE ONLY

**Receiving Official (Name) Date / Time Sign Print**

**Releasing Official (Name) Date / Time Print**

**Sentry Load Data: (Must Initial) Name Search Completed by:**
Clearance/Separate Checked by: ___

(OPTIONAL USE)
ARS Code: Staff Init.
Add AKA's:
Create Cash Account:
Deposit Cash Amt.
Detainers
Court
Clothing Bag #

Original-for ISM as Remanding-Removal receipt; Copy-for Control as Removal Receipt (NCIC); Copy-For Removing Official; Copy-for Control as Remanding Receipt (Inmate); Copy-INS-Alien in Custody.

(This form may be replicated via WP) This form replaces BP-S377(58) and BP-377(58) of JUL 91