EFTA00109757

# U.S. DEPARTMENT OF JUSTICE

## ARRESTING OFFICER WILD CHRISTIE AND REGISTERED MACC/MOOR

Name: Last
First
Middle

AKAAS:

Race (Check)  Sex (Check)  Ethnic Origin (Check)  D.O.B.  SSN:
B W A I  M F  Hispanic or Other

CHANGES
CHECK CATEGORY OF CHARACTERS:
PELZYMANOR  CIVIL CONTEMPLATION  MATERIAL WITNESS
OTHER

NARRATIVE:
TIU  USC:
NARRATIVE:
TIU  USC:
Title:
USC:

Date of Offense: 02/18/2014  Place of Arrest:

State of Birth  Country of Birth  Citizenship  Current-Address
1.5. U.S.

Height  Ft: 6.00  Hair: 190  Eyes: 60

Scars / Marks / Tattoos

Injuries / Medication

Emergency Contact: (Name, Address, Phone)

Arraigned Y N  Sentenced Y N  Special Handling: Y or Remarks:

IN  IN  IN

Remanding Official (Name) Sign  Agency/District  Phone/24 Hour Number
Print

OUT  OUT  OUT

Removing Official (Name) Sign  Agency/District  Phone/24 Hour Number
Print

## FOR BOP USE ONLY

Receiving Official (Name) Sign  Date, Time  Releasing Official (Name) Sign  Date / Time
Print

Sentry Load Date (Most Initial) Name Search Completed by:
Clearing/Separation Checked by:

OPTIONAL JURY  ARS Code:  Staff Init.
Add AKA:  Cash Account  Deposit Cash  Amt.
Count  Clothing Bag #

RIGHT THOMBPAINT

Original-for ISN as Remanding-Removal receipt; Copy-For Control as Removal Receipt (NIC); Copy-For Removing Official; Copy-For Control as Remanding Receipt (Immate); Copy-INS Allen in Custody.

This form may be replicated via WP.)



EFTA00109758

# J.S. DEPARTMENT OF JUSTICE

ARGUMENTS AFTERGERY WILL CONVERGE ALL RACQUETED DATA ON THIS FORM BEFORE TO COMMITTING TO MOVEMENT.

Name: Last First Middle

AKAa:

Race (Check) Sex (Check) Ethnic Origin (Check) D.O.B. SSN:
B W A I M F Hispanic or Other FBI: INS: Owner:

CHANGES CHECK GASCON OF CHARGES(S): MISDMEANOR MATERIAL WITNESS OTHER
NARRATIVE: TITLE: USC: Title: USC: Title: Date of Offense: Date of Arrest: Place of Arrest:

State of Birth Country of Birth Citizenship Current Address Zip Code

Height Ft: 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

Date of Offense: Date of Arrest:

IN IN IN IN Remanding Official (Name) Agency/District Phone/24 Hour Number Print

OUT OUT OUT Removing Official (Name) Agency/District Phone/24 Hour Number Print

FOR BOP USE ONLY

Receiving Official (Name) Date / Time Releasing Official (Name) Date / Time Sign Print

Print

Sentry Load Data (Must Initial) Name Search Completed by: Staff Init.
Clearance/Report Checked by: Create Cash Account.
Deposit Cash.
Court Clothing Bag

(OPTIONAL REQ) ASS Code Amt. Creation Cash Account Deposit Cash Court Clothing Bag

RIGHT THUMBRINT

Original-for ISM as Remanding-Removal receipt; Copy-for Control as Removal Receipt (NCIC); Copy-For Removing Official; Copy-for Control as Remanding Receipt (Immate); Copy-INS-Allen in Custody.

This form may be replicated via WP) BP-377(58) of JUL 91



Date / Time