LAW ENFORCEMENT SENSITIVE Taken into Federal custody by the following: - Street Arrest (not from a correctional/detention facility) - Custodial Arrest (from a correctional/detention facility) □ Writ Used (Must provide copy of writ) □ Prior Federal Arrest or Safekeeper - Register #: ___ - □ Safekeeper Location: ___ BIOGRAPHICAL INFORMATION Last Name: THOMAS First Name: MICHAEL Middle Name: Sex: ☐ M ☐ F ☐ Transgender Pregnant: ☐ Y ☐ N Race: B-Black/Black Hispanic Hair: BLACK Eyes: BROWN Height: ___ Weight: ___ DOB: ___ City of Birth: State/Country of Birth: Citizenship: USA FBI #: State ID#: Alien #: SSN: Resident Address/City/State/ZIP: Home Phone: Cell Phone Marital Status: Single COURT CASE Agency: FBI Agency ORI: NYFBINY00 Agent Last Name: First Name: Agent Phone #: Arrest Date: 11/19/2019 Location/Facility of Arrest: 290 BROADWAY FBI NY Court Docket #: ___ CR AUSA(s) Assigned: OFFENSE NCIC Code Charge Description Title/Code MAKING FALSE STATEMENTS 18 USC 1001 CONSPIRACY TO MAKE FALSE STATEMENTS 18 USC 371 Known Detainers/Warrants: ☑ N ☐ Y - Agency: (Must provide a copy of any detainers) CAUTIONS AND MEDICAL Long Term Medical Conditions (e.g., heart problems, diabetes, asthma, tuberculosis, HIV, AIDS, hepatitis, etc.): ☑ N ☐ Y Psychiatric/Emotionally Disturbed (e.g., mental health concerns, suicidal, etc.): ☑ N ☐ Y Injuries/Medical Ailments/Post-Op Recovery: ☑ N ☐ Y Do the above conditions require: Medical attention? ☑ N ☐ Y Medication? ☑ N ☐ Y Medical clearance by a licensed physician: ☑ N ☐ Y Is Defendant under the influence of drugs or alcohol: ☑ N ☐ Y Languages - English: ☑ N ☐ Y Limited Other Language: ☑ N ☐ Y - List: ___ U/LES | Form USM-312 | Rev. 11/17 | | :--- | :--- | Page 1 of 3 SDNY_MT_00000212 EFTA00140897 LAW ENFORCEMENT SENSITIVE

Security Cautions:
☐Current or former military	☒Current or former LE/corrections	☐Current or former intelligence
☐Current or former public official	☐Assault on LE/corrections	☐SAM subject or candidate
☐Eligible for diplomatic immunity	☐Leadership role	☐Separation needs(Describe below)
☐Threat to witness(Describe below)	☐CI(Describe below)	☐Other(Describe below)

Remarks:

ALIASES
	ALIAS Last Name	ALIAS First, MI	Remark	Date of Birth	SSN	State Driver's License

## ASSOCIATES / CO-DEFENDANTS / RELATIVES / CHILDREN / SIGNIFICANT OTHER

Relationship	Last Name	First, MI	Register #	Resident Address, City, State, ZIP Code	Phone
Co-Defendant	TOVA	NOEL	-

## MARKS

Scar/Mark/Tattoo(Specify)	Location	Description

## VEHICLES

Vehicle Year	Make	Model	Color(s)	Vehicle Style	State and Plate #	Registration Date	VIN

## LICENSES

License Number	License State

## MISCELLANEOUS NUMBERS

Miscellaneous Number	Type(Select from dropdown menu or type below)	Remarks(e.g., Issuing State or Country, etc.)

## OCCUPATIONS

Employment Address: 150 PARK ROW NEW YORK NY			Phone:
Start Date:	End Date:	Point of Contact:

## FINANCIAL

Bank Name	Account Type	Account #	Branch Address	Phone #

## MILITARY

Branch	Rank	Entry Date	Discharge Date	Discharge Type	Military Occupation	Remarks

## REMARKS Additional Information/Remarks/Continuation: U/LES | Form USM-312 | Rev. 11/17 | | :--- | :--- | Page 2 of 3 SDNY_MT_00000213 EFTA00140898 LAW ENFORCEMENT SENSITIVE # PROFILE ## Defendant Risks: *Requires remarks below* - Escapee - Organized Crime* - International Terrorist - Gang Member* - Multiple Defendants - Death Penalty Case ## Sex Offender: - Arrest - Conviction - Registered - Registration Violation + Add History ### Criminal History (Select from dropdown menu or type offense below) | Arrest (#) | Conviction (#) | | :--- | :--- | | NONE | | ### Remarks (e.g., name of gang or criminal organization, etc.): - Money Launderer - Kingpin - Violent Offender ## INTERNET SOURCE | Internet Source | Remarks (e.g., email address, website address, username, etc.) | | :--- | :--- | --- **NOTICE TO ARRESTING AGENTS:** As a courtesy, the USMS may temporarily hold an arrestee received by non-USMS personnel in the cellblock until the arresting agent(s) make arrangements for the prisoner's initial appearance before a United States Magistrate. A prisoner must remain the responsibility of the arresting agency until remanded to the custody of the USMS by the courts. When a courtesy host is allowed by the USMS to be housed in a USMS cellblock, a minimum of one agent from the arresting agency must be available to respond to the cellblock in order to address any issues with their prisoner (e.g., medical, disciplinary). If the arresting agency refuses to comply with USMS procedures, the courtesy hold may be refused. Meals are not provided by the USMS, and remain the responsibility of the arresting agent(s). ## ARRESTEE PROCESSING CHECKLIST **For Arresting Officer Only** - USM-312 (Personal History of Defendant) - Medical clearance (from licensed physician), if necessary - Copy of Arrest Warrant, if issued - Copy of Complaint, Information, or Indictment, if completed - Copy of Detainer(s), if issued - Copy of Writ, if applicable - Correctional facility discharge papers, if applicable - Correctional facility prisoner receipt, if applicable - Correctional facility medical summary, if applicable **Prepared By - Name:** Agency: FBI/NYPD Cell Phone: Date: 11/19/2019 **ARRESTEE PROCESSING CHECKLIST** **For USMS Personnel Only** - Confirm all arresting agent documentation is completed and inserted into prisoner's file - USM-312 (Personal History of Defendant) - reviewed, signed and dated by intake DUSM/DEO - USM-552 (Prisoner Medical Records Release Form) - completed, signed and dated by intake DUSM/DEO - USM-18 (Federal Prisoner Property Receipt) - completed, signed and dated by intake DUSM/DEO - USM-40/41 (Prisoner Remand) - inserted into prisoner's file - USM-130 (Prisoner Custody Alert Notice), if applicable - inserted into prisoner's file - FD-249 (Fingerprint Card) - printed and inserted into prisoner's file - Prisoner Photograph (from Booking Package) - printed and inserted into prisoner's file **Reviewed By:** Badge #: Date: U/LES | Form USM-312 | Rev. 11/17 | | :--- | :--- | Page 3 of 3 SDNY_MT_0000214