EFTA00110596

BP-S377.058 PRISONER REMAND CDFRM

U.S. DEPARTMENT OF JUSTICE

FEDERAL BUREAU OF PRISONS

# ARRESTING OFFICER WILL COMPLETE ALL REQUIRED DATA ON THIS FORM PRIOR TO COMMITTING TO COC/ARREST.

| Name: Last | First | Middle | AKAs: |
| :--- | :--- | :--- | :--- |
| Race (Check) | Sex (Check) | Ethnic Origin (Check) | D.O.B. | SSN: | FBI: INS: Other: |
| B _ N _ A _ I | M _ F | Hispanic or _ Other | | | |

## CHARGES

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

## OTHER

**NARRATIVE:**
- Title: ___
- NARRATIVE: ___
- Title: ___

**Date of Offense:** ___ Date of Arrest: ___ Place of Arrest: ___

### State of Birth

| Country of Birth | Citizenship | Current Address | Zip Code |
| :--- | :--- | :--- | :--- |
| Weight | Hair | Eyes | Scars / Marks / Tattoos |

### Height Ft:
In:

### Injuries / Medication

Emergency Contact:(Name, Address, Phone Number)

### Arraigned _Y _N

Sentenced _Y _N

Special Handling: _Y or _N

Remarks:

### IN

IN IN IN IN IN IN

Remanding Official (Name)
Sign
Print

Agency/District

Phone/24 Hour Number

### OUT

OUT OUT OUT

Removal Sign
Print

Agency/District

Phone/24 Hour Number

### FOR BOP USE ONLY

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

Releasing Official (Name) Date / Time Sign Print

Sentry Load Data: (Must Initial) Name Search Completed by: (Optional USP) Staff Init. Add AKA'B Create Cash Account Deposit Cash Amt. Detainers Court Clothing Bag #

RIGHT TEAM PRINT

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-Allen in Custody.



(This form may be replicated via WP) This form replaces BP-S377(58) and BP-377(58) of JUL 91

EFTA00110597

| | | |
| :--- | :--- | :--- |
| BP-S377.058 | PRISONER REMAND | CDFRM |
| FEB 04 | | |

U. S. DEPARTMENT OF JUSTICE

<table><tr><td>Last Name</td></tr><tr><td>EPSTEIN</td></tr><tr><td>First Name</td></tr><tr><td>JEFFREY</td></tr><tr><td>Middle Name</td></tr><tr><td>EDWARD</td></tr></table>

<table border="1"><tr><td>Name: Last</td><td>First</td></tr><tr><td colspan="2">AKAs:</td></tr></table>



HL 6' 0'' WL 185



HR. GRY EY. BLU





REG# 76318-054 NYM 76318-054 EPSTEIN



# AKAs:

**Race (Check)**
- _B_ W _A_ I

**Sex (Check)**
- M _F_

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

**D.O.B.**

**SSN:**

**FBI:**
**INS:**
**Other:**

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

## OTHER
NARRATIVE:
Title: USC:
NARRATIVE:
Title: USC:

Date of Offense: Date of Arrest: State of Birth Country of Birth Citizenship Current Address Zip Code

Height
Ft: In:
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 Remarks:

## IN
IN IN IN IN

## Remanding Official (Name)
Sign
Print

Agency/District

Phone/24 Hour Number

## OUT
OUT OUT OUT

## Rem Sign
Print

Agency/District

Phone/24 Hour Number

## FOR BOP USE ONLY

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

Sign Print

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

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

(OPTIONAL USE Staff Init.
Add AKA:
Create Cash Account
Deposit Cash Amt.
Detainers Court
Clothing Bag #

RIGHT THUMBSPRINT

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