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 |
Remanding Official (Name) Sign Print¶
Agency/District Phone/24 Hour Number¶
- 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¶