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est Warrant. if issued Copy of Complaint. Information. or Indictment. if completed O Copy Of Uletainens). if issued O Copy of Writ. if applicable K Correctional facility discharge papas. if applicable O Correctional facility prisoner receipt. ilapplicable K Correctional facility medical summary. if applicab
soner refuses to sign, note that in the signature block. All refusals should be immediately reported to the Otftce of Interagency Medical Services. Prisoner Services Division. The completed USM form 552 is to be retained in the prisoner's files, Section I - USMS Prisoner Information I. nisoner Name (Last. First. MO 2 US
rest 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. if applicable K Correctional facility prisoner receipt. if applicable o Correctional facility medical summary. if appli
soner refuses to sign. note that in the signature block. All refusals should be immediately repotted to the Office of Interagency Medical Services. Prisoner Services Division. The completed USM Form 552 is to be retained in the prisoner's files. Section - USMS Prisoner In formation I. Prisoner Nam (Lass First, SD) :t SM
t Warrant, if issued K Copy of Complaint, Information, or Indictment. if completed K Copy of Detainer(s), if issued K Copy of Writ, if applicable K Correctional facility discharge papers. if applicable K Correctional facility prisoner receipt. if applicable K Correctional facility medical summary. if applic
soner refuses to sign, note that in the signature block. All refusals should be immediately reported to the Office of Interagency Medical Services, Prisoner Services Division. The completed Form USM-552 is to be retained in the prisoner's files. Section I - USMS Prisoner Information I. Prisoner Name (Last, First, MI) Ne
t Warrant, if issued O Copy of Complaint, Information, or Indictment, if completed O Copy of Detainer(s), if issued O Copy of Writ, if applicable K Correctional facility discharge papers, if applicable O Correctional facility prisoner receipt, if applicable K Correctional facility medical summary, if applic
soner refuses to sign, note that in the signature block. All refusals should be immediately reported to the Office of Interagency Medical Services, Prisoner Services Division. The completed Form USM-552 is to be retained in the prisoner's files. Section I - USMS Prisoner Information I. Prisoner Name (Last, First, MI) 11
Entities connected to both K Correctional and Prisoner Services Division

Department of Justice
ORGANIZATIONthe Office of Interagency Medical Services
ORGANIZATION
Jeffrey Epstein
PERSONCopy of Complaint
ORGANIZATIONDistrict File
ORGANIZATIONBooking Package
ORGANIZATIONK SAM
ORGANIZATIONUSMS Intake Officer
ORGANIZATION
United States
LOCATIONthe United States Marshals Service
ORGANIZATIONK Separation
ORGANIZATIONArrest Warrant
PERSONMedical Insurance Information
ORGANIZATIONLocation/Facility of Arrest
ORGANIZATIONLeon Black
PERSONArrestee
ORGANIZATIONPrisoner Medical Records Release Form)-
ORGANIZATION
Julie K. Brown
PERSONAlbany
LOCATION
NEW YORK NY
LOCATION