LAW ENFORCEMENT SENSUTIVE U.S. Department of Justice United States Marshal: Personal History of Defendant Taken into Federal custody by the following: Street Arrest (not from a correctional detention facility) SANTI Used (Must provide cops of writ) PEK WT hee (CD Custodial Arrest (from a correctional detention facility) (D Priot Federal Arrest or Safckeeper - Register DD Safekeeper Location: BIOGRAPHICAL INFORMATION Last Name: First Name: (CF Transgender Pregnant: [)\ Eyes: BLVE Height: 67 State/Country of Birth: Z\ City of Birth: FBI 4: \¢ itizenship: — State ID#: Alien == : Resident Address/City/State/Z1P: F & 7/7 LL ew YOKK Cell Phone: L120 fafital Status: Agency OR tiome Phone: COURT CASE Agent Last Name: First Name: Agent Phone 4: Location/Facility of Arrest: Arrest Date: zx, Court Docket 4: EL/7 47 - LULLIET , RB fol C0 re TL Mew Seas AUSA(s) Assigned: A OFFENSE [NCIC Code __|Charze Deseription SEX Zewep7e korg Ligh D |TitlsCode a A P< /, Kaown Detainers/Warrants: [Ry ' 1) Y - Agency: LL bopO CR (Must provide # copy of any detainers) CAUTIONS AND MEDICAL Long Term Medical Conditions (c.g, heart problems, diabetes, asthmu, tuberculosis, HEV. AIDS, hepatitis. ete PRIN OY Oy Psychiatric/Emotionally Disturbed (eg. meatal health concerns, suicidal. ete.): Injuries/Medical Ailments/Post-Op Recovery: =| N Oy De the above conditions require: Medical attention? voy Medication? voy Meclical clearance by a licensed physician: “H ‘OY Is Defendant under the influence of drugs or alcohol: TAN Oy Languages - English: N i t OC Limited Other Language: N DY-List Security Cautions: Cyrrent or former military CD Current or former 1. corrections () Current of former intellivence fren or former public official CD Assault on LE corrections (_] SAM subject or candidate ligibl Kible for diplomatic immunity LD Leadership role () Separation needs (Deserihe Aelow) (CD Threat to witness (Dexerihe blows D0 Ct Deseriby below) (CD Other (Mexeribe beluw) ULES Form USM-312 Page tof 3 Rev 117 USAO_ 002258 EFTA_00020168 EFTA00169861

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LAW ENFORCEMENT SENSITIVE Remarks: ALIASES ALIAS Last Name jAt HAS First, MI | Remark Date of Birth SSN _ State Driver's License ASSOCIATES CO-DEFENDANES RELATIVES CUILDRENS SIGNTFIC ANT OTTER Resident Address. City. State. Relationship Last Name | First, Mi Register # ZIP Code Phone MARKS Scar/Mark/Tattoo (Specify) | Location ___|Deseription _ _ _ Vehicle | State and Registration Year | Make _| Moe : Color(s) \\ chicle Style | Plate 4 Date _VEIN _ LICENSES License Number License State MISCELLANEOUS NIEMBERS _Miscellaneous Number | Type (Select from dropdown menu or ype below) | Remarks (¢.2.. Insuing State or Country. etc.) OCCLPATIONS Oce pation: {| Company/Employer Name: Sov; as MT Cg lads Phone: Point of Contact: Employment “Addre Start Date: FINANCIAL _[Bank Name ; | Account Type __|Account # __ Branch Address |Phone # MILITARY Discharge Type | Military Occupation | Remarks RESIARKS Additional Information/Remarks/Continuation: Defendant Risks: *Reyuires remarks below Sex Offender: 7) Escapee () Planned Murder (CD Arrest (CD Conviction C) Organized Crime* (_) Protected Witness C) Registered (D Registration Violation C2 International Terrorist (J Domestic Terrorist (CD Gang Member* CD Significant Criminal History (CO Multiple Defendants DD Death Penalty Case Form USM.312 Rev 11/17 USAO_ 002259 EFTA_00020169 EFTA00169862

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LAW ENFORCEMENT SENSITIVE Arrest (#) riminal History (Select from dropdown menu or type offense below) a ma tits name of gang or criminal organization, ete.): (J Money Launderer 7) Kingpin (CD Violent Offender , username, etc.) ; As acourtesy, 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 arresting 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 celiblock. 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 (e.g. 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 For USMS Personnel Onty USM-312 (Personal History of Defendant) (J Contin all arresting agent documentition is completed and | F inserted into prisoner's file Medival clearance (from licensed physician). if necessary = “ ; - oO USM-312 (Personal History of Defendant) - review ed Opy of Arrest Warrant, if issued signed and dated hy iitake DESM DIO | Copy of Complaint, Information, or Indictment, if completed | — [J] USM-S52 (Prisoner Medical Records Release Form) - () Copy of Detainerts). if issued completed. signed and dated by intake DU SME DELO (J Copy of Writ. if applicable (J) USM-18 (Federal Prisoner Property Receipt) - completed. C Correctional facility discharye papers. if applicable signed und dated by intuke DUSM DEO (0) Correctional facility prisoner receipt, if applicable [) USM-40:41 (Prisoner Remand) - inverted ine prisoner's file (CD Correctional facility medical summary, if Prepared By - Name: Agency: WV (J USM-130 (Prisoner Custody Alert Notice). if applicable- — } nt inserted inte prisoner's file (DD FD-249 (Fingerprint Card) - printed and inserted inte ' prisoner's file CD) Prisoner Photograph (from Booking Package) « printed amd inserted inte prisoner's file Reviewed By: Fine) Jt pt ber (bro thee) ae [eae JWEK FP STEM USAO_ 002260 EFTA_00020170 EFTA00169863