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

U.S. DEPARTMENT OF JUSTICE

FEDERAL BUREAU OF PRISONS

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

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

## CHARGES

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

### OTHER

#### NARRATIVE:
Title: USC:_
NARRATIVE: USC:_

Date of Offense: Date of Arrest: Place 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

Remanding Official (Name) Sign Print

Agency/District Phone/24 Hour Number

## OUT OUT OUT OUT

Removing Official (Name) Sign Print

Agency/District Phone/24 Hour Number

## FOR BOP USE ONLY

Receiving Official (Name) Date / Time Sign Print

Releasing Official (Name) Date / Time Print

Sentry Load Data: (Must Initial) Name Search Completed by:

Clearance/Separate Checked by:

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

RIGHT THUMBPRINT



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

EFTA00120669

EFTA00120670

EFTA00120671

EFTA00120672