EFTA00109639

| BP-S377.058 | PRISONER REMAND | CDFRM |
| :--- | :--- | :--- |
| FEB 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.

<table border="1"><tr><td>Name: Last Russo</td><td>First Robert</td></tr></table>

<table border="1"><tr><td>Race(Check)
_B_W_A_I</td><td>Sex(Check)
_M_F</td><td>Ethnic Origin(Ch
_Hispanic or_C</td></tr></table>

<table><thead><tr><th>Last Name</th><th></th><th></th></tr></thead><tbody><tr><td>RUSSO</td><td></td><td></td></tr><tr><td>First Name</td><td></td><td></td></tr><tr><td>ROBERT</td><td></td><td></td></tr><tr><td>Middle Name</td><td>Suffix</td><td></td></tr><tr><td>ANDREW</td><td></td><td></td></tr><tr><td>Height</td><td>Weight</td><td></td></tr><tr><td>5'11''</td><td>185</td><td></td></tr><tr><td>Hair</td><td></td><td>Eye</td></tr><tr><td>GRAY</td><td></td><td>BROWN</td></tr><tr><td>Regno</td><td></td><td>Facility</td></tr><tr><td>77749-054</td><td></td><td>NYM</td></tr></tbody></table>





CHECK CATEGORY OF CHARGES(S):
___ FELONY ___ MISDEMEANOR ___ CIVIL CONTENT ___ MATERIAL WIINESS ___

OTHER

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


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

<table border="1"><tr><td>State of Birth</td><td colspan="2">Country of Birth</td><td>Citizenship</td><td>Current Address</td><td>Zip Code</td></tr><tr><td>Height
Ft: In:</td><td>Weight</td><td>Hair</td><td>Eyes</td><td colspan="2">Scars / Marks / Tattoos</td></tr><tr><td colspan="4">Injuries / Medication</td><td colspan="2">Emergency Contact:(Name, Address, Phone Number)</td></tr></table>

<table border="1"><tr><td>Arraigned<br>___Y___N</td><td>Sentenced<br>___Y___N</td><td>Special Handling: __Y or __N<br>Remarks:</td></tr></table>

<table border="1"><tr><td>IN</td><td>IN</td><td>IN</td><td>IN</td></tr><tr><td>Remanding Official(Name) Sign Print</td><td>Agency/District FB0P</td><td colspan="2">Phone/24 Hour Number 696-936-6460</td></tr></table>

<table border="1"><tr><td>OUT</td><td>OUT</td><td>OUT</td><td>OUT</td></tr><tr><td>Removing Official(Name) Sign Print</td><td>Agency/District FBHP</td><td colspan="2">Phone/24 Hour Number 6968366400</td></tr></table>

FOR BOP USE ONLY

<table border="1"><tr><td>Receiving Official(Name) Sign</td><td>Date / Time</td><td>Releasing Official(Name) Sign</td><td>Date / Time</td></tr><tr><td>Print</td><td></td><td>Print</td><td>OS/OS/N</td></tr></table>

<table border="1"><tr><td>Sentry Load Data: (Must Initial)
Name Search Completed by:
Clearance/Separate Checked by:</td><td>(OPTIONAL USE)
ARS Code___ Staff Init.___
Add AKA&#x27;s ___
Create Cash Account___
Deposit Cash ___ Amt.
Detainers___
Court___
Clothing Bag #___</td><td>RIGHT THUMBPRINT</td></tr></table>

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