LAW ENFORCEMENT SENSTTIVE U.S. Department of Justice United States Marshals Service Personal History of Defendant Taken into Federal custody by the following: Street Arrest (not from a correctional/detention facility) SATII Used (Must provide copy of writ) PORK CaF bee Ape (CO Custodial Arrest (from a correctional /detention facility) (1D Price Federal Arrest or Safekeeper - Register #: : - | LD Safekceper Location: BIOGRAPTIIC AL INFORMATION Last Name: Middle Name: Weight: SES | DOE 1c itizenship: FBI #: State ID#: 27/ £L. Cell Phon| ss 12 Mafital Status: [rst Ses | Agent Phone 4: Location/Facility of Arrest: 7. CLAORO LAKME LEER G fod La walfL Mew VeLay Resident Address/City/State/ZIP: Home Phone: COURT CAS Agency: 04 FBZ Agent Last Name: Court Docket #: CR = AUSA(s) Assigned: OFFENSE NCIC Code ? Title/Code USC Z/ Kaown Detainers/Warrants: [AY o Y - Agency (Must provide a cops of ans detuiners) CAUTIONS AND MEDICAL Long Term Medical Conditions (c.y.. heart problems, diabetes, asthma. tuberculosis, HIV, AIDS, hepatitis. ete): ARN oO Y Psy chiatric/Emotionally Disturbed (¢.g.. mental health concerns, suicidal. ete.): ip x OY Injuries/Medical Ailments/Post-Op Recovery: = NOY Do the above conditions require: Medical attention? Noy Medication? ‘oy —— - rr re Medical clearance by a licensed physician: 3) x OY ts Defendant under the influence of drugs or alcohol: AN Oy Languages - English: N = t C0 Limited Other Language: N OOY- List: Security Cautions: Ny rrent or former military ( Current or former I.E corrections CD Current of former intelligence 1 or former public official CD Assault on LE ‘corrections (J SAM subject or candidate ligible for diplomatic immunity DD Leadership role (2 Separation needs (Dexerihe hely (CD Threat to witness (Deseribe below) CD Cl (Describe below) (DD Other (Deserihe beluw) ULES Form USM-312 Page 1 of 3 Rev 1117 EFTA00026660

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LAW ENFORCEMENT SENSITIVE Remarks: ALIASES ALIAS Last Name ALIAS First, Ml | Remark Date of Birth SSN State Driver's License ASSOCTATES / CO-DEFENDANES RELATIVES (CULO REN J SIGNIFICANT OTMER Resident Address, City, State. First, MI ZIP Code {Phone Relationship Last Name VARKS wer — ad Location ; = Description VEHICLES Vehicle | Year : v ; \¥ ehicle Styte_ State and Registration Plate # Date VIN LICENSES | License Number License State MISCELLANEOUS NEMBERS | Miscellaneous Number | Type (Select from dropdown menu or type below) Remarks (¢.¢.. lysuing State or Country. etc.) OCCUPATIONS Occupation: Secor Ln QL ad | Company/Employer Name: Sj, y, Mut Com Employment Address: Vi REE Lands | Phone i Start Date: End Date: Point of Contact: __ Bank Name Phone # Account Type | Account # ___ Branch Address Discharge Date Diseharge Type | Military Occupation | Remarks $+ Fs — —— Additional Information/Remarks/Continuation: Defendant Risks: *Requirex remarks below Sex Offender: C) Eseapee (FD Planned Murder DD Arrest (0 Conviction (CC) Organized Crime* (2 Protected Witness DZ) Registered CD Registration Violation C) International Terrorist (J Domestic Terrorist (CD Gang Member* LD Significant Criminal History D) Multiple Defendants (CD Death Penalty Case ULES Form USM.312 Page 2 of 3 Rev 11/17 EFTA00026661

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LAW ENFORCEMENT SENSITIVE Arrest (#)} T Conviction (#) “¢ riminal H istory (Select from dropdown menu or ipe offense beluw) | oni ts name of gang or criminal organization, ete.): (J Money Launderer 7) Kingpin CZ Violent Offender Internet Source Remarks (e.g., em dress, website address, username, etc.) ee - -_ — NOTICE TO ARRESTING AGENTS; As a courtesy. the USMS May temporarily hold an arrestee received by non-USMS personnel in the cellblock until the arresting agent(s) make arrangements for the prisoner's initial appearance before a United States Magistrate. A prisoner remains the responsibility of the arresiing agency until remanded to the custody of the USMS by the courts 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 cellblock in order to address any issues with their prisoner (¢.4.. medical. disciplinary ), If the arresting agency refuses to comply with USMS procedures. the courtesy hold may be refused. Meals are not provided by the USMS. and remain the responsibility of the arresting agent(s) ARRESTEE PROCESSING CHECKLIST ARRESTEE PROCESSING CHECKLIST For Arresting Officer Onty For USMS Personnel Only usu. 312 (Personal History of Defendant) oO Confirm all arresting agent documentation is completed and | inserted into prisoner's file Medival clearance (from licensed physician). it necessary USM-3!2 (Personal History of Defendant) - review edd signed and dated by intake DASMEDILO Copy of Complaint, Information, or Indictment, if completed] - | “opy of Arrest Warrant, if issued C] USM-352 (Prisoner Medical Records Release Form) - | CD Copy of Detainerts), if issued completed. signed! and dated by intake DU SME DLO CD Copy of Writ, if applicable (] ('SM-18 (Federal Prisoner Property Receipt) - completed (CD Correctional facility discharge papers. if applicable signed and dated by intake DUSM DEO (1) Correctional facility prisoner receipt. if applicable L] USM-40/41 (Prisoner Remand) - inserted imo prisoner's file | (1) Correctional facility medical summary. if applicable | () USM-130 (Prisoner Custody Alen Notice). if applicable - | inserted into prisoner's file Prepar } (FD FD-249 (Fingerprint Card) - printed and inserted ine prisoner's file () Prisoner Photograph (from Booking Package) - printéd und inserted into prisoner's file finty, fier ber (bho hea ) Le [Dae JYHEK EpsTEW EFTA00026662