EFTA00109679¶
| ARRESTING OFFICER WILL COMPLETE ALL REQUIRED DATA ON THIS FORM PRIOR TO COMMITTING TO MCC/MDCs. | Height | Weight | |
| Name: Last | First | 5'09" | 160 |
| Hair | |||
| BLACK | |||
| Regno | |||
| 76328-054 | |||
AKAs: NONE¶
Race (Check) __B __W __A __I Sex (Check) __M __F Ethnic Origin (Check) Hispanic or Other D.O.B. SSN: FBI: INS: Other:¶
CHARGES CHECK CATEGORY OF CHARGES(S): ___ FELONT ___ MISDEMEANOR ___ CIVIL CONTEMPT ___ MATERIAL WITNESS¶
OTHER NARRATIVE: Title: __ USC: 549 Poss Drugs NARRATIVE: Title: __ USC: 846 Conspiracy¶
Date of Offense: __ 8/31/19 Date of Arrest: __ 8/31/19 Place of Arrest: __ 8/31/19¶
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 646-712-3228¶
OUT OUT OUT OUT OUT¶
Removing Official (Name) Sign Print Agency/District Phone/24 Hour Number 646-721-0164¶
FOR BOP USE ONLY¶
Receiving Official (Name) Sign Print Date / Time Releasing Official (Name) Sign Print¶
Sentry Load Date: (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 #¶
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¶