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¶