BP-A03O8 ADMINISTRATIVE DETENTION ORDER U.S. DEPARTMENT OF JUSTICE JAn7 FEDERAL BUREAU OF PRISONS eS NEW YORK MCC Institution Date/Time; 07-29-2019 12:21 (Name/Title) SUBJECT ; Placementof____ EPSTEIN, JEFFREYEDWARD ___ Reg. No__76318-054_ in Administrative Detention v (a) Is pending an investigation for a violation of Bureau regulations; {b) 1s pending an SIS investigation. (c) Is pending investigation or trial fora criminal act; (4) ts tobe admitted to Administrative Detention ___(1)_ Since the inmate has requested admission for protection; | 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. (f} Is pending classification; or {9) Is terminating confinement in Disciplinary Segregation and has been ordered into Administrative Detention by the Warden's designee. it is this Correctional Supervisor's decision based on all the circumstances that the above named inmate's continued presence in the general population poses a serious threat to life, property, self, staff, other inmates, of to the security or orderly running of the institution because* PENDING UOC FOR CODE 228 SELF-MUTILATION Therefore, the above named inmate is to be placed in Administrative Detention until further notice. The inmate received a copy of this Order on (date / time) i Date Staff Witness Signature/P rinted Name. Supervisor 24 hour review of placement: Signature/Printed 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 - Operation Supervisor - Administrative Detention Unit; Copy — Psychology; Copy - Central File POF Prescribed by P5270 (Replaces BP-A0306 of JAN 88.) CO N F | DE NTIAL SDNY_00009518 EFTA00033865