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Page 1140 a. ? . a “os BP o2es ‘ ' INCIDENT REPORT ANAT U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS art | — Incident Report : institution: MCC New York ncident Report Number: nmate’s Name: . Register Number: ate of Incident: Epstein , Jeffery 76318-054 07/23/2019 5. Place of Incide 7. Assignment: Unassigned SHU N-Tier Cell 124 ¥. Incident: Seif Mutilation . Vale And lime: arewen? 3:30am ime Incident Report Delivered: B, _ The Committee is referring the Charge(s) to the DHO for further He: Cc. The Committee advised the inmate of its finding and of the right to file an appeal within 20 calendar days. 18. A. Itis the finding of the committee that you: Committed the Prohibited Act as charged: Did not Commit a Prohibited Act. Committed Prohibited Act Code (s). 19. Committee Decision is Based on Specific Evidence as Follows: AHO _ ~ eg TZ a SRE ART _ OO ALL A A OY. Sr Zz CTT t | ame): ember (Typ lems ou of heavy rule are use only. Begin entries wi ié number 7 and work up. ies not compile will De voided by staff. Distribute: Original-Central File Record; COPY-1-DHO: COPY-2-Inmate after UDC Action; COPY 3-Inmate within 24 hours of Part | Preparation Prescribed by P5270 Replaces BP-A0288 of AUG 11 PDF DOJ-OGR- 00025362