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ange in the reason for placement is to be noted in this What If Me reason for placement changes, the inmate must receive a copy &this form): Date of Next Review. 07.23.2019 Printed Name and Signe Segregation Review Official ea the Reviewing Authority and Date Signed. M. I Record Copy - Central File TN'
(2 Or 3 Days) 3 Day Review Action Taken on the Above Date Continue In Special Housing Unit Date Reviewed 07.19.2019 Pelted Name/Signature -St IL RECORD REVIEW. (To be done weekly in U'- absence, beginning after the in.person 7 day review. and continuing every week between each in-person 30 day review.) D
the reason for placement is to be noted in this section. If the reason for placement changes, the inmate must receive a copy of this form): Date of Next Review. 07.23.2019 lion Review Official Or the Reviewing Authority and Date Signed. This form replaces BP-295(52) dated January 1988 Page I of 1 7/19/20
or 3 Days) 3 Day Review Acton Taken on ine AbOve Date: Continue In Special Housing Unit Printed Name/Signature: =MEI Date Reviewed 07.19.2019 IL RECORD REVIEW. (To be done weekly in the inmate's absence, beginning after the in.person 7 day review. and continuing every week between each in-person 30 day rev
n the reason for placement Is to be noted in this section. If the reason for placement changes. the inmate must receive a copy of this form) Date 01 Next Review 01.23-2019 Printed Name and Sign Segregation Renew Official or the Renewing Authority and Date Signed Record Copy - Central File This form repla
L (2 or 3 Days) 3 Day Review Action Taken on um Above Deb: Continue In Special Housing Unit mead NameisIgnalaret Data Ftedavrad 07-19-2019 IL RECORD REVIEW. (To be done wedge? M the train's abloom% begin:AM° after the N-omen 7 day review. and conertuing every week between each in-person 30 day antaw.)
Entities connected to both Next Review and IL RECORD REVIEW
Special Housing Unit
ORGANIZATIONLeon Black
PERSONthe Reviewing Authority
ORGANIZATIONSpecial Housing Review Form
ORGANIZATIONthe Segregation Review
ORGANIZATIONFederal Bureau of Prisons
ORGANIZATIONActon Taken
LOCATIONCOMPLETED - CONTINUE PROCESSING
ORGANIZATIONMedical Staff
ORGANIZATION
Julie K. Brown
PERSONCopy - Operation Supervisor
ORGANIZATIONR. PROTO
ORGANIZATIONNYM-NEW YORK MCC
ORGANIZATIONPGM REVIEW
ORGANIZATIONUNT MGR
ORGANIZATIONOHO Report
ORGANIZATIONEl Continue
ORGANIZATIONSHU Review
ORGANIZATIONNYM CALLOUTS
PERSONPagelofl
PERSON