BP-A0308 JAN 17 ADMINISTRATIVE DETENTION ORDER DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS
NEW YORK MCC
Institution
TO: Special Housing Unit Officer Date/Time: 07-16-2019 15:50 FROM: LIEUTENANT, (Name/Title) SUBJECT : Placement of___, Reg. No.___, in Administrative Detention ___(a) Is pending an investigation for a violation of Bureau regulations; (b) Is pending an SIS investigation. ___(c) Is pending investigation or trial for a criminal act; ___(d) Is to be admitted to Administrative Detention ___(1) Since the inmate has requested admission for protection; I hereby request placement in Administrative Detention for my own protection. Inmate Signature/Register No.: ___ Staff Witness Printed Name Signature: ___ (2) Since a serious threat exists to safety as perceived by staff, although person has not requested admission; referral of the necessary information will be forwarded for an appropriate hearing by the SRO. ___(e) Is pending transfer or is in holdover status during transfer. ___(f) Is pending classification; or ___(g) Is terminating confinement in Disciplinary Segregation and has been ordered into Administrative Detention by the designee. It is this Correctional decision based on all the circumstances that the above named continued presence in the general population poses a serious threat to life, property, self, staff, other inmates, or to the security or orderly running of the institution because* PENDING SIS INVESTIGATION/ THREAT ASSESSMENT Therefore, the above named inmate is to be placed in Administrative Detention until further notice. The Inmate received a copy of this Order on StaffWitness Signature/Printed Name_ Supervisor 24 hour review of placement: Signature/Printed name. - In the case of DHO action, reference to that order is sufficient. In other cases, the Correctional supervisor will make an Independent review and decision, which is documented here. Record Copy - Inmate Concerned (not necessary if placement is a result of holdover status); Copy - Captain; Copy - Unit Manager; Copy - Operation Supervisor - Administrative Detention Unit; Copy — Psychology; Copy - Central File PDF Prescribed by P5270 [Replaces BP-A0308 of JAN 88.] EFTA00110614 BP-A0308 JAN 17 ADMINISTRATIVE DETENTION ORDER DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS **(a)** Is pending an investigation for a violation of Bureau regulations; ✓ (b) Is pending an SIS investigation. ___(c) Is pending investigation or trial for a criminal act; ___(d) Is to be admitted to Administrative Detention ___(1) Since the inmate has requested admission for protection; I hereby request placement in Administrative Detention for my own protection. Inmate Signature/Register No.: ___ Staff Witness Printed Name Signature: ___ (2) Since a serious threat exists to safety as perceived by staff, although person has not requested admission; referral of the necessary information will be forwarded for an appropriate hearing by the SRO. ___(e) Is pending transfer or is in holdover status during transfer. ___(f) Is pending classification; or ___(g) Is terminating confinement in Disciplinary Segregation and has been ordered into Administrative Detention by the designee. It is this Correctional decision based on all the circumstances that the above named continued presence in the general population poses a serious threat to life, property, self, staff, other inmates, or to the security or orderly running of the institution because* PENDING SIS INVESTIGATION/ THREAT ASSESSMENT Therefore, the above named inmate is to be placed in Administrative Detention until further notice. The inmate received a copy of this Order on (date / time) ___ ess Signature/Printed Name___Date ___ Supervisor 24 hour review of placement: Signature/Printed name___ - In the case of DHO action, reference to that order is sufficient. In other cases, the Correctional supervisor will make an independent review and decision, which is documented here. Record Copy - Inmate Concerned (not necessary if placement is a result of holdover status); Copy - Captain; Copy - Unit Manager; Copy - Operation Supervisor - Administrative Detention Unit; Copy – Psychology; Copy - Central File PDF Prescribed by P5270 [Replaces BP-A0308 of JAN 88.]