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G CHECKLIST For A mating Officer Only is cusm-312 (Personal History of Defendant) edical clearance (from licensed physician), if necessary opy of Arrest Warrant. if issued Copy of Complaint. Information. or Indictment. ircompleted 0 Copy of Deuiner(s). if issued O Copy of Writ. if applicable K Correction
if applicable - inserted into prisoner's file K FD-249 (Fingerprint Card) - printed and inserted ink) prisoner's.file K Prisoner Photograph (from Booking Package) - printed and interim/ into prisoner's file Reviewed By: Badge U: Date: U/LES Page 3 of 3 For USM.312 Rev 11117 EFTA00106174 UNITED STATE
ING CHECKLIST For Arresting (Wirer Only *USM-3I2 (Personal History of Defendant) Medical clearance (from licensed physician). if necessary opy of Arrest Warrant. if issued Copy of Complaint. Information. or Indictment. if completed C3 Copy of Deminerts I. if issued O Copy of Writ. if applicable O Correcti
ce), if applicable - inserted into prisoner's file K FD-249 (Fingerprint Card). printed and invenal into pristmerWile O Prisoner Photograph (from Booking Package) printed and inserted into prisoner's file Reviewed By: /71-eptierz 6gRehlte.) ifi lt< e rte/A/ (940 cr13— 2122_ LILES Page 3 of 3 Badge N
ECKLIST For ',nesting Officer Only 4 USM-312 (Personal History of Defendant) Medical clearance (from licensed physician). ii'necessaly ip 'opy of Arrest Warrant. if issued Copy of Complaint. Information. or Indictment, if completed O Copy of Detainer(s). if issued O Copy of Writ. if applicable O Correctio
, if applicable - inserted into prisoner's file K FD-249 (Fingerprint Card) - printed and inserted into prisoner'sfile O Prisoner Photograph (from Booking Package) - printed and inserted inm prisoner's file Reviewed By: Badge fl: Date: U/LES Page 3 of 3 Form USM-312 Rev. 11/17 EFTA00257772 AKAs: BP-
Entities connected to both Arrest Warrant and Booking Package

Department of Justice
ORGANIZATION
Jeffrey Epstein
PERSONSouthern District
LOCATIONCopy of Complaint
ORGANIZATIONPrisoner Services Division
ORGANIZATIONLocation/Facility of Arrest
ORGANIZATIONK Correctional
ORGANIZATIONthe Office of Interagency Medical Services
ORGANIZATION
Julie K. Brown
PERSONUnited Slates Marshals Service
ORGANIZATIONOPTIONAL
ORGANIZATIONNO PROPERTY NO PROPERTY NO
ORGANIZATIONPrisoner Medical Records Release Form
ORGANIZATIONPlate N
ORGANIZATIONLeon Black
PERSONECK ATEGORY OF CHARGES(S
ORGANIZATIONControl as Remanding Receipt
ORGANIZATIONBirth SSN
PERSONK SAM
ORGANIZATIONK Safekeeper Location
ORGANIZATION