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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
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
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
if applicable - inserted into prisoner's file K FD-249 (Fingerprint Card) - printed and inserted into prisoner's file K Prisoner Photograph (from Booking Package) - printed and inserted into prisoner's file Reviewed By: Badge U: U/113 Page 3 of 3 Date: Form USM.312 Rev 11/17 SDNY_TN_00020914 EFTA0014
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
if applicable - inserted into prisoner's file K FD-249 (Fingerprint Card) - printed and inverted into prisoner's file K Prisoner Photograph (from Booking Package) - printed and inserted Into prisoner's file Reviewed By: Badge X: U/LES Page 3 of 3 Date: Form tISM-312 Rev. 11/17 SDNY_MT_00000214 EFTA00
soner refuses to sign. note that in the signature block. All (chisels should be immediately reported 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 I - IBMS Prison( IaforrinatIon I. Prisoner Name (Iasi. Fin'. P11) le
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
Entities connected to both Prisoner Services Division and Booking Package

Department of Justice
ORGANIZATIONthe Office of Interagency Medical Services
ORGANIZATION
Jeffrey Epstein
PERSONSouthern District
LOCATIONControl as Remanding Receipt
ORGANIZATIONUnited States Marshals Service
ORGANIZATIONCopy of Complaint
ORGANIZATIONOPTIONAL
ORGANIZATIONDistrict File
ORGANIZATIONK Correctional
ORGANIZATIONNO PROPERTY NO PROPERTY NO
ORGANIZATIONthe United States Marshals Service
ORGANIZATIONArrest Warrant
PERSONUSMS Intake Officer
ORGANIZATIONMedical Insurance Information
ORGANIZATIONLocation/Facility of Arrest
ORGANIZATIONECK ATEGORY OF CHARGES(S
ORGANIZATIONBirth SSN
PERSONK Separation
ORGANIZATIONK SAM
ORGANIZATION