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Page 73 Incident #: NYM-19- 0076 Form 583 Report of Incident Date/Time Of Incident: 7/23/2019 1:27 AM Submitted By: Medical Attention Required: No Injury Category: No Injury Sexual Assault: No Name: |PG: Medical 4 tion Required: No Injury Category: No Injury Sexual Assault: No Attention Required: No Injury Category: No Injury Sexual Assault: No Kow6}, (by eC) Name: Medical Attention Required: No Injury Category: No Injury Sexual Assault: No Name: Medical Attention Required: No Injury Category: No Injury Sexual Assault: No Name: Medical Attention Required: No UNCLASSIFIED/LIMITED OFFICIAL USE ONLY/LAW ENFORCEMENT SENSITIVE Section 3: Others Involved Person Type: Staff Death: No Staff Injury by Inmate: Person Type: Staff Death: No Staff Injury by Inmate: Person Type: Staff Death: No Staff Injury by Inmate: Person Type: Staff Death: No Staff Injury by Inmate: Person Type: Staff Death: No Staff Injury by Inmate: Person Type: Staff Death: No No No No No No This document is marked Unclassified/Limited Official Use Only/Law Enforcement Sensitive and may be disseminated, with proper attribution, to active Law Enforcement, DOD, or U.S. Intelligence Agencies. This document, or any segment/attachment thereof, may not be released without the approval of the Bureau of Prisons to any media sources, any non-law enforcement entity, the general public or those without a “need to know.” It contains information that may be exempt from public release under the provisions of the Privacy Act (5 U.S.C. 552). 2 of 3 DOJ-OGR- 00024712