EFTA00109734¶
U.S. DEPARTMENT OF JUSTICE¶
ARRESTING OFFICER WILL COMPLETE ALL REQUIRED DATA ON THIS FORM PRIOR TO COMMITTING TO MCC/MDCs.¶
Name: Last MUTIMURA First: PARFAIT Middle: NIYOMUGABO Weight: 5’09” 160 Hair: BLACK Facility: NYM¶
AKAs: PARFAIT MUTIMURA NIYOMUGABO¶
Race (Check) B W A I Sex (Check) M F Ethnic Origin (Check) Hispanic or Other D.O.B. 00 SSN: FBI: INS; Other:¶
CHARGES¶
CHECK CATEGORY OF CHARGES(S):¶
- FELONY
- MISDEMEANOR
- CIVIL CONTEMPT
- MATERIAL WITNESS OTHER
Date of Offense: 08/09/2018 Date of Arrest: 08/09/2018 Place of Arrest: JFK Arpt. Term. 4¶
State of Birth Country of Birth Rwanda Citizenship United States Current Address Zip Code¶
Height FT:5 In:9 Weight 160 Hair Black Eyes Brown Scars / Marks / Tattoos¶
Injuries / Medication¶
| N/A |
Arraigned Y N Sentenced Y N Special Handling: Y or N Remarks:¶
IN IN IN IN IN¶
Remanding Official (Name) Sign Agency/District Phone/24 Hour Number Print¶
OUT OUT OUT OUT¶
Removing Official (Name) Sign Agency/District Phone/24 Hour Number Print¶
FOR BOP USE ONLY¶
Receiving Official (Name) Sign Date/Time Release Official (Name) Date/Time Print¶
Sentry Load Date (Must Initial) Name Search completed by: [Optional Use] Staff Init. ARB Code ARB Policy Create Cash Account Deposit Cash Detainers Count Clothing Bag #¶
RIGHT THUMSPRINT¶
Original-for ISM as Remanding-Removal receipt; Copy-for Control as Removal Receipt (NCIC); Copy-For NMS All-in-Custody¶
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.¶
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