BP-S377.050 PRISONER REMAND FEB 04
BP-S377.050 PRISONER REMAND FEB 04
U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS
ARRESTING OFFICER WILL COMPLETE LL 'REQUIRED DATA ON THIS FORM PRIOR TO COMMI /NG TO:, ' MCC/MDCs. Register Number
Name: Las:
MiddUe
AKAs:
Race (Check)
B IM A I Sex (Check)
F Ethnic Origin (Check)
_Hispanic on Other D.O.B. SSN:
CHARGES
CHECK CATEGORY OF CHARGES(S): FELONY MISDEMEANOR CIVIL CONTEMPT MATERIAL WITNESS ... OTHER
NARRATIVE:
Title: USC: NARRATIVE7 --Title: USC:
1 am••••• ."'
:
i • „ V PJ
Date of Offense: Date of Arrest: Place of Arrest:
or. ' State of Birth Country.of Birth Citizenship .Current Address Zip Code :.
Height
Ft: In: Weight Hair.Eyes. Scars / Marks / Tattoos
Injuries / Medication Emergency Contest: -(Name, - Address, Phone Number)
Arraigned
Y N Sentenced
—_ Y __ N Special Handling: Y or N Remarks:
NVIPRm Remanding Official (Name) I Agency/District Sign
Print Phone/24 Hour Number
Sign.
Print (:';grn ,Y)
Receiving Official (Name) Sign
Print Date / Time Releasing,Official. (Name) Sign ,. . a
Print Cate / Time y/District ?hone/24 Hour Number
Sentry Load Data: (Must Initial) Name Search Completed by:
Clearance/Separate Checked by: (OPTION
ARS Code
Add AKA'
Create Cash Account Deposit Cash Amt. Detainers
Court
Clothing Bag 4 Staff Init. RIGHT THUm PRINT
Original -for ISM-as Remanding -Removal receipt; Copy-for Control as Removal -Receipt (NCIC)it)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-Sir/mat mnA Ors.,'”ora.
EFTA00109695