EFTA00109731

| 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/MDCS.

| Name: Last | First | Middle | AKAs: |
| :--- | :--- | :--- | :--- |
| Race (Check) | Sex (Check) | Ethnic Origin (Check) | D.O.B. | SSN: |
| B W A I | N F | Hispanic or Other | | FBI: INS: Other: |

## CHARGES

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

## OTHER

NARRATIVE:
Title: USC:
NARRATIVE: 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 Print |

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

(OPTIONAL USE)
ANS Code # Staff Init.
Add AKA#
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 (NCIO); Copy-For Removing Official; Copy-for Control as Remanding Receipt (Immate); 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