LAW ENFORCEMENT SENSTINE
LAW ENFORCEMENT SENSTINE
US. Department of Justice
United States Marshals Service Personal History of Defendant
Taken to Federal custody by the following:
Street Arrest (not from a correctional detentkm twilit))
O Custodial Arrest (front a conectionaLdetention facility)i• eitriit Used (Must pro. ide copy of writ) /7fece, 7- aescefec.C.4...-T"
O Prior Federal Arrest or Safekecper • Register u:
O Safekecper Location:
Ii111c,il \Iglu \I \ 1 \I III\
Hair:
City of Birth:
FBI U:
Resident Address/City/State/ZIP:9 4.-.7trzFint Name:
State/Coun ry of Birth:
State IDN:
Home Phone: Cell Phon . Zerdel, Middle Name: Sag e/
/o Marital Status: S
I (II RI
Agency:
Agent Last Name:
Agent Phone Mt
Location/Facility of Arrest:
Court Docket Pt CR lint Name:
Arrest Date: 7Agency O rAiy,16
ae a =e2 m SA(s) Assigned:
Title/Code OFFENSE
NCR: (ode Charge Description 6-017,7Areakil
usc 3 7/ known DetainersAVa reams: ' O Y - Agency: (Hoer proskle a coo Cr lay detainers)
/ \I \ \II Olt \I
Long Term Medical Conditions rag.. heart problems. diabetes. asthma. tuberculosis. IIIV. A llis. hepaliti'. O V
lik Psychiatric/Emotionally Disturbed (cry. mental heath emmenm.iiiiitidal. ma: N O 1'
Injuries/Medical Ailments/Post-Op Recovery: % O Y
Do the above conditions requ re:
Aledical attention? N
Medication? N
Medical clearance by a licensed physician: N O A'
Is Defendant under the influence of drugs or alcohol: 11.N O 1.
Languages - English: iykN Ercr O Limited
, Other language: N ❑ Y List:
Security Cautions:
Current or former military
or former public official
bgibic rot diplomatic immunity
O Threat to witness (Describe ham, . O Current or former 1.1E corrections
O Assault on LE/corrections
O Leadership role
CI (Describe Amer O Current or former intelligence
O SAM subject or candidate
O Separation needs /l test...the belo'
El Other (Describe below.
IPLES
raw I 44() Form US1.4.312
Rev 11/17
EFTA00026660
LAW ENFORCEMENT SENSITIVE
Remarks:
I I \SI
I ALIAS Last Name ALIAS First, MI Remark !Date of Bitch ISSN Stale Driser's license
\ II I. ',I I % • I US ( \ .Nil \ 1)! III U
(Relationship Last Name j First, MI Register # Resident Address. City. State.
ZIP Code Phone
•
\I
ISeartaridTattoo (Specify) (Location
fif Description
I 111( 1 •
Vehicle
%ear Make Model Colorist Vehicle Style State and
Plate a Date YIN Registration
t It
I license Number License State
I I 1 \\I (()I • \I R•
'Miscellaneous Number It rype (Select from dretpaiwn raw,. or type Mend I Remarks (e.g.. liaittiseSiale•rCeeatr:•
(I1 ( I \ I ION-,
Occupation: Sat.,' O.^ Company/Employer Name:
Employment Address: ViRaw
Start Dale A/ oe J
Phone
End Date: Point of Contact:
'lank Name Account Type I Account tt Branch Address Phone Sc
Mil II \U\
FA/
ritriwa; Rank I Entry
DateDischarge T
Date Discharge Type Military Occupation Remarks
R %I \Ilk%
Additional Information/Remarks/Continuation:
PR( Wit .I.
Defendant Risks: *Requires malaria below
❑ Escaixr O Planned Murder
❑ Organized Crimes O Protected Witness
O International Terrorist O Domestic Terrorist
O Gang \lumber' O Significant Criminal
O Multiple Defendants O Death Penalty Case
U I.ES
Page 2 or 3 Sex Offender:
O Arrest
O Registered ❑ ci Uonsietion
Registration iul at ion
Form USIA 312
Rev 11/17
EFTA00026661
LAW ENFORCIiNIENT smrovii
Criminal History Mira front dropdmen menu IV ON offense below) Arrest (H) Conviction (II)
Remarks name of gang or criminal organization, etc.): (e.g.,
Pr
Money Launderer ❑ Kingpin 0 Violent Offender
IN I l'RNI I 1/4.OI to I
Internet Source }Remarks (e.g., email address, website address, usernamc. etc.)
NOTICE TO ARRESTING AGENTS: As a courtesy. the USMS may temporarily hold an arrestee received by non-USSIS personnel in the cellblock until the arresting agent(s) make arrangements for the prisoner's initial appearance before a United States Magistrate. A prisoner remains the responsibility of the arresting agency until remanded to the custody of the USMS by the coons. When a courtesy hold 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 cellbloci. in order to address any issues with their prisoner (e.g.. medical. discipliner) I. If the arresting agency refuses to comply with USMS procedures. the courtesy hold may be refused. Meals arc not provided by the USMS. and remain the responsibility of the arresting agent(s).
ARRESTEE PROCESSING CHECKLIST
For Arresting Officer Only
4USM-3I2 (Personal Ilium- of Defendant)
Medical clearance (from licensed physician). if ncvcssar)
'op) of Arrest Warrant, if issued
Copy of C'omplaint. Information. or Indictment. if completed
CI Copy of Detaincifik if issued
r'opy of Writ, if applicable
El Correctional facility discharge papers. if applicable
Correctional facility prisoner receipt. if applicable
Correctional facility medical summary. if applicable
Prepared By - Name:
Agency: ilf110. ivy riS-4 "-
af)://f Cell Pinot Date:
gill /A/4C, et 1/wz.) A RRESTEE PRO( 'ES.SING
For ISMS Personnel Only
• Confinn all arresting agent documentation is completed and
inserted into prisoner's file
• USNI-3 12 (Personal History of I kfctidant) coke c./.
signedunr/dm/hyhmate frl St/ l)&)
• t SM-552 (Prisoner Medical Records Release Form I -
convicted vignetiond dam/ by intuit.' 1 N Nil DEO
O I %M-18 (Federal Prisoner Properly Receipt) • edonp/cre.f.
signer/um/ glared by inbtke h1 511 DEO
❑ USNI—I0/4I (Prisoner Remand) - inverted ima prisoner:vide
• VSM-I30 (Prisoner Custody Alen Notice). if applicable -
inserted imo /rLYolk'r Ties'
• ED•249 (Fingerprint Card) - primer/and inserted boo
pristinetit file
O Prisoner Photograph ( from Booking Package) - priorredind
inserted jilts' prkillkt .A /lie
Reviewed By:
Badge 0: Date:
lU LES
Page 3 of 3 Form USM•312
Rev 11/17
EFTA00026662