EFTA00134665.pdf

sP Ao3os ADMINISTRATIVE DETENTION ORDER U.S. DEPARTMENT OF JUSTICE JAN IT FEDERAL BUREAU OF PRISONS TO: Special H ing Unil Officer FROM. IEUTENANT (Name/Tele) NEWYORK MCC Insutubca Date/Time. 07-10-2019 SUBJECT : Placement of EPSTEIN. JEFFERY . Reg. No. 7-10-2019 in Administrative Detention (a) Is pending an Investigation for a violation of Bureau regulations. (b) Is pending an SIS investigation. (c) Is penc5ng investigation or trial for a crininatact: (d) Is to be admitted to Administrative Detention (1) Sincethe inmate has requested admissionfor protection: I herebyrequestplacement in Administrative Detentionfor my own protection Inmate Signature/Register No.'. Staff Witness Printed Name Signature: (2) Since a serious threat exists to individual's safety as perceived by staff. although person has not requested admission: referral of the necessary information will be forwarded for an appropriate hearing by the SRO (e) Is pending transfer or is in holdover status during transfer. 1 (f) Is pending classification; or (g) Is terminating confinement In Disciplinary Segregation and has been ordered into Administrative Detention by the Warden's designee. Ills Nis Correctional Supervisor's decision based on all the circumstances that the above named inmate' s continued presence in the general population poses a senses threat to life, property, self, staff, other inmates, or lo the sects* or orderly running of the institution because' PENDING CLASSIFICATION Therefore. the above named inmate is to be placed in Admkistrative Detention unei further notice. The inmate received a copy of this Order on (date/time) 0 -19 StaffWitnessSignattrePrinted Name Date 7 Supervisor 24 hour review of placement: Signalure/Pririted name • In the case of DHO action. reference to that order is sufficient. In other cases, the Correctional supervisor will make an independent review and decision. which is documented here. Record Copy • Inmate Concerned (not necessary if placement is a result of holdover status); Copy - Captain; Copy - Unit Manager. Copy - Ope rvisor - Adminstrative Detention Unit; Copy— Psychology. Copy - Central File PDF Prescribed by P5270 (Replaces BP-A0308 of JAN 88.) SDNY_00000905 Ern_00000129 EFTA00134665