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) eriii Used (Must provide cop) of wit) Atir Ce4 r ‘'-+c'C04..--r- O Custodial Arrest (from a correctionaLdmention facility) 0 Priur Federal Attest or Salikeeper • Register r': • Sofekeeper Location: O Itl y.0 \rim INFORM vrios Last Narae: ,C7:60A/ I First Name: a t,/ e Middle Name: edmi ted Sex: r ❑ Transgender Pregnant: O Y Race: yf Rain 6 Eyes: 49,4,4C Height: C Weight Afert DUB: /-21/1-:" City of Birth: 4, State/Coun ry of Birth: 4/ Citizenship 70, C FBI N: State IDN: Alien : SSN: Resident Address/City/StaleTZIP: 9 a;„7.,Air , •e-trVOICKi /OO llome Phone Cell Phone: tat Status; el l It I \NI Agt.er NY /en' Agency ORE Agent Phone N: Location/Facility of Arrest: Court Docket it: AUSA(s) Assigned: OF FENN' Nr'IC Code barge Description ..SeYreAte nCfrinti 495( Title/Code 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? N ❑V Medication? N %Wifel clearance by a hemmed physician: ION O Languages - English: Other Language: , ars, N litc- Is Defendant under the influenceof drugs or alcohol: IAN O Limited - List: Security Cautions: C rrcnt or former military O Current or former 1.1correction El Current or fanner intelligence or tanner public official O Assault on LE COnteliOnS O SAM subject or candidate ligible for diplomatic immunity O Leadership role O Separation needs in:scribe below) O Threat to witness kscribe &shoe) ❑ ci (IA:scribe helm) O Other 'Describe belutc) U.LES Form USM-312 l'atte I of) 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 Slate Driver's License ,V..."O( I ( (s.1)LF END V% RI . I \ \NI < ) 1 111 1t 1 Resident Address. City. State. Relationship Last Name I First. MI Register N ZIP Code Phone NI kith's Scar/. Iarkftattuu (Specif)) Location Description Vehicle 11ear VIN I It \kJ license Number license State I I t . \\I (It \I \Ir..' Miscellaneous Number Type (Selectfrom 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\ Entry Discharge 1Rank Date Date Discharge Type Minter, Occupation Remarks KINI %I'Mion:0 Information/Remarks/Continuation: PROTILI. Defendant Risks: *Requires remark,. befotr Se• Offender: O Escapee 0 Planned Murder 0 Arrest 0 Conviction O Organized Crime' 0 Protected Witness 0 Registered 0 Reltisicalioil \ lolation O International errorist 0 Domestic Terrorist O Gang Alember• 0 Significant Criminal Ilium) O Multiple Defendants 0 Death Penalty Case U l.ES Form US/4.312 hue 2013 Rev 11/17 USAO_002259 EFTA_00020169 EFTA00169862  LAW ENFORCEMENT SENSITIVE Criminal History (Stiedfrom eltspdmen menu or opt silense being j Arrest Con% ict ion (N) Remarks p\) e.g., 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 United a 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 ARRESTEE PROCESSING CHECKLIST Pm'Imaging Officer Ono- lot ISMS Personnel Only 14 USW!? (Personal History of Defendant) • 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 Copy of Complaint. Information. or Indictment. if completed • t'SNI-552 (Prisoner Medical Records )(ukase form - O Copy of Ik12111Cif 5). if issued completed figneil amldinedhl' linahe fin) O Copy of Writ. if applicable • t S\I.18 (Federal Prisoner Property Rixeipt) • amplemt O Correctional facility discharge papers. if applicable Mum%I andMosulhy huaQ Al S11!1M) O Correctional facility prisoner receipt. if applicable • USM-10.-II (Prisoner Remand) - isuerted Amp prisoner's file O Correctional facility medical summary. if ausolirable ▪ LISM-130 (Prisoner Custody Alert Notice). if applicable - Prepared By - Name: ntreriestimurrlsoner's.file • EIN249 (Fingerprint Cud)• child %DAWN, MID prixinkt% Jilt O Prisoner Photograph ( from Booking Package) • 101k41.11ki baffled finer prixonerIA file Res iewed By: Badge M: I Date: 1-42* /get/ Aee' (8,PciA,,z U LES Font USM-312 Pap: 3 of 3 Rev ill17 USAO_002260 EFTA_00020170 EFTA00169863