EFTA00109733

975

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

| :--- | :--- | :--- |

| FEP-04. | | |

U. S. DEPARTMENT OF JUSTICE

FEDERAL BUREAU OF PRISONS

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

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

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

**Sex (Check)**
- M F

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

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

**TRN:**
- INS:
- Other:

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

**OTHER**

**HARRATIVE:**
Title: ___ USC: ___
NARRATIVE: Title: ___ USC: ___

**Date of Offense:** 19___ 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 "CARREON" |
| Injuries / Medication N/A | | | 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 DEA SOYNE**

**Phone/24 Hour Number 616-1189931**

**OUT** | OUT | OUT | OUT |

**Removing Official (Name) Sign Print**

**Agency/District**

**Phone/24 Hour Number**

## FOR BOP USE ONLY

**Receiving Official (Name) Date / Time Receiving Official (Name) Date / Time**

**Sign Print**

**Print**

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

*(OPTIONAL USE)* Staff Init.

*Add AS#* 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