EFTA00109629

| | |
| :--- | :--- |
| BP-S377.058 | |
| FEB 04 | |

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 MCC/MDCs.

| Name: Last | First | Middle | AKAs: |
| :--- | :--- | :--- | :--- |
| Race (Check) | Sex (Check) | Ethnic Origin (Check) | D.O.B. | SSN: |
| _B_W_A_I | _M_F | Hispanic or Other | | FBI: INS: Other: |

## CHARGES

### CHECK CATEGORY OF CHARGES(S):
- ___ FELONY ___
- ___ MISDEMEANOR ___
- ___ CIVIL CONTEMPT ___
- ___ MATERIAL WITNESS

## OTHER

### NARRATIVE:
Title: ___ USC:__
NARRATIVE:
Title: ___ USC:__

Date of Offense: Date of Arrest: Place of Arrest: ___

State of Birth Country of Birth Citizenship Current Address Zip Code

Height Ft: In: Weight Hair Eyes 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 IN

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

OUT OUT 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. Create Cash Account Deposit Cash Amt. Detainers Court 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 (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

EFTA00109630

| BP-S377.058 | PRISONER REMAND | CDFRM |
| :--- | :--- | :--- |
| FEP.04 | | |





U.S. DEPARTMENT OF JUSTICE

FEDERAL BUREAU OF PRISONS

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

| Name: Last | First | Middle | Register Number |
| :--- | :--- | :--- | :--- |
| AKAs: | | | |

**Race (Check)**
- B _ W _ A _ I

**Sex (Check)**
- M

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

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

**FEI:**
- INS:
- Other:

## CHARGES
### CHECK CATEGORY OF CHARGES(S):
- ___ FELONY ___ MISDEMEANOR ___ CIVIL CONTEMPT ___ MATERIAL WITNESS

## OTHER
- NARRATIVE:
- Title: ___ USC:__
- NARRATIVE:
- Title: ___ USC:__

Date of Offense: ___ Date of Arrest: ___ Place of Arrest: ___

State of Birth | Country of Birth | Citizenship | Current Address | Zip Code

Height
Ft: In: | Weight | Hair | Eyes | 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

OUT 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 Sign Print

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

(OPTIONAL USE)
ARS Code __ Staff Init.__
ARX AFT __
Create Cash Account __
Deposit Cash __ Amt.__
Detainers __ Court.__
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 (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