EFTA00169861.pdf

LAW ENFORCEMENT SENSMVI? .S. Department of Justice Unitial States Marshals Sen ice Personal History of Defendant Taken • to Federal custody by the folio% lag: Street Arrest (not from a correctional detention facility) O Custodial Arrest (from a correctionaLdmention facility) eriii Used (Must provide cop) of wit) Atir Ce4 r ‘'-+c'C04..--r- 0 Priur Federal Attest or Salikeeper • Register r': • O Sofekeeper Location: Itl y.0 \rim INFORM vrios Last Narae: ,C7:60A/ I First Name: at,/ e Middle Name: edmi ted Sex: r K Transgender Pregnant: O Y Race: yf Afert DUB: /-21/1-:" 70, C Rain 6 Eyes: 49,4,4C Height: C Weight City of Birth: 4, State/Coun ry of Birth: 4/ Citizenship FBI N: State IDN: Alien : SSN: Resident Address/City/StaleTZIP: 9 a;„7.,Air , llome Phone Cell Phone: ell It I \NI Agt.er NY /en' Agent Phone N: Location/Facility of Arrest: Court Docket it: •e-trVOICKi AUSA(s) Assigned: /OO tat Status; Agency ORE OF FENN' Nr'IC Code barge Description ..SeYreAtenCfrinti 495( us(: 37/ kease DetainersAVarranit: ' QY. Agency: INIaai amide a rap, area, detainer%) {CM I \ l••• %ND NII DI( %I. Long Term Medical Conditions Aran problcass.dialwitt. asthma. tuberculosis. I111'. etc.): O I( Payetsfatinc/EnintiOnally Disturbed lea.. wand health cowrie.. wieldst. N O N. Injuries/Medical Ailments/Post-Op Recovery:* O Do the above conditions ref) re: Medical attention? Medication? N ❑V N Title/Code %Wifel clearance by a hemmed physician: ION O Is Defendant under the influenceof drugs or alcohol: IAN O Languages - English: ars, litc- Limited , Other Language: N - List: Security Cautions: C rrcnt or former military or tanner public official ligible for diplomatic immunity O Threat to witness kscribe &shoe) O Current or former 1.1 correction O Assault on LE COnteliOnS O Leadership role K ci (IA:scribe helm) U.LES l'atte I of) El Current or fanner intelligence O SAM subject or candidate O Separation needs in:scribe below) O Other 'Describe belutc) Form USM-312 Rev 11(17 USAO_002258 EFTA_00020168 EFTA00169861 LAW iiNFORCEMIA MASH Remarks I ALIAS Last Name I ALIAS First, MI Remark Date of Birth SSN ,V..."O( I ( (s.1)LF END V% RI . I \ \NI < ) 1 111 1t Relationship 1 I Last Name First. MI Slate Driver's License Resident Address. City. State. Register N ZIP Code Phone NI kith's Scar/. Iarkftattuu (Specif)) Location Vehicle 11 ear Description license State VIN I It \kJ license Number I I t . \\I (It \I \Ir..' Miscellaneous Number Type (Select from ingdown mena or ope Mend l Remarks tea.. Maine State or Counirs.ric.) U( I I V I ION" Occupation: goLGfi / Company/Employer Name: Employment Address: Vigarel .. * 0,1A/ Start Date: I End Dale: [Point of Contact: \\I I \I Bank Name maul Type Account N Branch Address Phone N \III I I \It\ 1 Rank Entry Date Discharge Date Discharge Type Minter, Occupation Remarks KINI %I'Mion:0 Information/Remarks/Continuation: PROTIL I. Defendant Risks: *Requires remark,. befotr O Escapee 0 Planned Murder O Organized Crime' 0 Protected Witness O International errorist 0 Domestic Terrorist O Gang Alember• 0 Significant Criminal Ilium) O Multiple Defendants 0 Death Penalty Case U l.ES hue 2013 Se• Offender: 0 Arrest 0 Registered 0 Conviction 0 Reltisicalioil \ lolation Form US/4.312 Rev 11/17 USAO_002259 EFTA_00020169 EFTA00169862 LAW ENFORCEMENT SENSITIVE j Criminal History (Stied from eltspdmen menu or opt silense being Arrest Con% ict ion (N) p\) g. Remarks e. , name of gang or criminal organization. etc.): /SY O Money Launderer O Kingpin O Viokni Offender IN !ERNI I ‘1)1 10 I I Internet Source !Remarks (e.g., email address, webs'', address. osernamc. etc.) NOTICE TO ARRESTING AGENTS: As a courtesy. the USMS may temporarily hold an Kmiec received by non.USNIS personnel in the eellblock until the wresting 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 eellblock in order to address any issues with their prisoner (e.g.. medical. disciplinary). 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 resting agent(s). ARRESTEE PROCESSING f'llECK LIST Pm 'Imaging Officer Ono 14 - USW!? (Personal History of Defendant) Copy of Complaint. Information. or Indictment. if completed O Copy of Ik12111Cif 5). if issued O Copy of Writ. if applicable O Correctional facility discharge papers. if applicable O Correctional facility prisoner receipt. if applicable O Correctional facility medical summary. if ausolirable Prepared By - Name: 1-42* /get/ Aee' (8,PciA,,z ARRESTEE PROCESSING CHECKLIST lot ISMS Personnel Only • Confinn all arresting agent documentation is completed and inserted into prisoner's file fl l',13.1-3 i 2 (Personal History of Ikrendant I - revive ed. stguedonr/tArtet/hy MEM.: 10 5%! MO • t'SNI-552 (Prisoner Medical Records )(ukase form - completed figneil aml dined hl' linahe fin) • t S\I.18 (Federal Prisoner Property Rixeipt) • amplemt Mum% I and Mosul hy huaQ Al S11 !1M) • USM-10.-II (Prisoner Remand) - isuerted Amp prisoner's file ▪ LISM-130 (Prisoner Custody Alert Notice). if applicable - ntreriestimurrlsoner's.file • EIN249 (Fingerprint Cud)• prixinkt% Jilt O Prisoner Photograph ( from Booking Package) • 101k41.11ki baffled finer prixonerIA file child %DAWN, MID Res iewed By: Badge M: I Date: U LES Pap: 3 of 3 Font USM-312 Rev ill17 USAO_002260 EFTA_00020170 EFTA00169863