EFTA00109760

## MC

# PRISONER REMAND

## J.S. DEPARTMENT OF JUSTICE

### ARRESTING OFFICER WILL COMPLETE ALL REQUIRED DAYS IN THIS SCREW PRICE TO COMMITTING TO MECAMAGES:

| Name: Last | B | W | A | I | M | F | Sex (Check) | Ethnic Origin (Check) | D.O.B. | SSN: |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| AKA: | | | | | | | | | | PRE INS: Other |

**Race (Check):** B | W | A | I | M | F | Sex (Check) | Ethnic Origin (Check) | D.O.B. | SSN: 17853346-03-29**

**CHARGES CHECK CATEGORY OF CHARGES(S):** WITNESS/MANORER
MATERIAL WITNESS
OTHER

**NARRATIVE:**
THE NARRATIVE: USC:
Title: USC:

Date of Offense: Date of Arrest: Place of Arrest: Place of Arrest:

| State of Birth | Country of Birth | Citizenship | Current Address | Zip Code |
| :--- | :--- | :--- | :--- | :--- |
| Height In: | Weight | Hair | Eyes | Scars / Marks / Tattoos |
| Injuries / Medication | | | | |

**Arranged N Sentenced Y Remitted V or Remarked:**

OUT OUT OUT

**Remanding Official (Name) Sign** Agency/District Phone/24 Hour Number
Print 212-351-7200

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

---

### FOR BOP USE ONLY

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

**Sentry Load Data (Name Initial) Name SearchCompleted by:**
Clearing/Sequencing Selected by:
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 (Immate); Copy-NNA-Allen in Custody.

(This form may be replicated via WP)

This form replaces BP-3377(58) and BP-377(58) of JUL 91



EFTA00109761

BP-S377.058 PRISONER REMAND

# U.S. DEPARTMENT OF JUSTICE

## ARSENSING OFFICER WITH COMPLETE ALL REQUIRED MEMORANDUM SHOULD BE READY TO CONVEYING TO NCOVID-19.

Name: Last Name First Middle

### AKAS:

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

## CHANGES CHECK CATEGORY OF CHARACTERS(S): MISURMEANOR CIVIL CONTEMPLATION MATERIAL WITNESS OTHER

## NARRATIVE(P):
Title: USC: 8146

## NARRATIVE(V):
Title: USC:

Date of Offense: Date of Arrest: Place of Arrest:

State of Birth Country of Birth Citizenship Current Address
Height FT In: Weight Hair Eyes Scars / Marks / Tattoos
Injuries / Medication Emergency Contact:(Name, Address, Phone Number)

## Arranged LY N Sentenced N Remarks:

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

Sentry Load Report Completed by: ARS Code Staff This.
Name Search Complied by: Credit Cash Account Deposit Cash Amt.
Contractors Clothing Bag #

Clearance/Separate Checked by:

RIGHT THUMPRINT

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

(This form may be replicated via WF)

This form replaces BP-5377(58) and BP-377(58) of JUL 91