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fficer 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 Correctional facility discharge papers.
ULES Paget oft Set Offender: K Anus K Registered K K Conviction Registration Violation Form USM•312 Rev 11/17 EFTA00106176 sirloins mates Marshals Service (USMS) PRISONER MEDICAL RECORDS RELEASE FORM ::43rwaTTIC;N:;, smiko• ; 4 eustatiknoi by die USMS ionise Officer Sections ii AG ill are to be comp
fficer Only 1Sc 1.1SM-312 (Personal History of Defendant) edical clearance (from licensed physician), if necessary opy of Arrest Woman. if issued Copy of Complaint. Information. or Indictment. if completed K Copy of Detainer(s). if issued El Copy of Writ, if applicable D Correctional facility discharge papers
ULES Page 2 of I See Offender O Aunt K Registered K K Conviction Registration Violation Form USM•312 Rev 11/17 EFTA00152423 ..t pas autes Marshals Service (USMS) PRISONER MEDICAL RECORDS RELEASE FORM ::4317:1;:.771ON:;. itt tot! tbriipivivd by Ule USiviS intake Officer. Sections ii AG iii are ro be
Officer Only 'USM-3 I 2 (Personal History of Defendant) edical clearance (from licensed physician). if necessary opy of Arrest Warranl if issued Copy of Complaint. Information. or Indictment. if compkted O Copy of Detainer(s). if issued K Copy of Writ. if applicable • Correctional facility discharge papers.
nder: CI Arrest ID Registered K E Conviction Registration Violation Form USU-312 Rev 11/17 USAO_002266 EFTA_00020176 EFTA00169869 ltal awes Marshals Service (USMS) PRISONER MEDICAL RECORDS RELEASE FORM iv a its cimipicimi uy oil: USMS intake Officer. Sections ii & iii are to be completed by the prisone
Entities connected to both Copy of Complaint and Marshals Service

Jeffrey Epstein
PERSON
Department of Justice
ORGANIZATIONSouthern District
LOCATIONPrisoner Services Division
ORGANIZATIONOPTIONAL
ORGANIZATIONControl as Remanding Receipt
ORGANIZATIONthe Office of Interagency Medical Services
ORGANIZATION
United States
LOCATIONUnited States Marshals Service
ORGANIZATIONUSMS 312
ORGANIZATIONNO PROPERTY NO PROPERTY NO
ORGANIZATIONBirth SSN
PERSONAttache
ORGANIZATIONPrisoner Medical Records Release Form
ORGANIZATIONREMANDS
ORGANIZATIOND O.B.
ORGANIZATIONInanacitons
ORGANIZATIONFBI
ORGANIZATIONArrestee
ORGANIZATIONK USM-552
ORGANIZATION