EFTA00104959.pdf

ADMINISTRATIVE DETENTION ORDER U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEVVYORK MCC Institution Date/rime 07-10.2019 TO' Special FROM . (Name/Tale) 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 pending investigation or trial for a aininai act: (d) Is to be admitted to Administrative Detention (1) Since the inmate has requested admission for protection: I hereby request placement in Administrative Detention for 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. ✓ (I) Is pending classification; or (g) Is terminating confinement In Disciplinary Segregation and has been ordered Into AdnenisbaUnt Detention by the Warden's designee It is the Correctional SupenAsors 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. We above named Inmate b to be placed in Adminletraive Detention unit hither notice. The innate received a copy of this Order on (date / time) 1-0 5 -I? StaffWitness Signature/Printed Name Date 1- / C7`•t Supervisor 24 hour review of placement: SignalurefPrinted name - In the case of DHO action. reference to that order is sufficient. In other cases. the Correctional supervisor %me make an independent review and decision. which is documented here. Record Copy - Inmate Concerned (not necessary/placement is a result of holdover status); Copy - Captain: Copy - Unit Manager. Copy - Oper n rvsor - Administrative Detention Urit; Copy- Psychology. Copy - Central File COPY PDF Prescribed by P5270 (Res:races BP-A0308 of JAN 88.) it 6 EFTA00104959