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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
TTIC;N:;, smiko• ; 4 eustatiknoi by die USMS ionise Officer Sections ii AG ill are to be completed by the prisoner. Section may be completed by die USMS Intake Officer if the prisoner is unable • or unwilling, but Section HI must be signed by the prisoner. If prisoner refuses to sign. note that in the signature bl
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
to me while in the custody of the United States Marshals Service, and for infectious disease clearances. Signature of Prisoner Date Signature of USMS Intake Officer Date Original—Prisoner File Copy to District File Copy Upon Transfer Form USM-552 Est. 6/98 SDNY_TN_00020917 EFTA00140914 Repository Inquir
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
to me while in the custody of the United States Marshals Service, and for infectious disease clearances. Signature of Prisoner Date Signature of USMS Intake Officer Date Original--Prisoner File Copy to District File Copy Upon Transfer Rem USM-552 Est. 6/98 SONY N1T_00000217 EFTA00140902 Message Detail
Entities connected to both Booking Package and USMS Intake Officer

Department of Justice
ORGANIZATIONthe Office of Interagency Medical Services
ORGANIZATIONPrisoner Services Division
ORGANIZATIONDistrict File
ORGANIZATIONK Correctional
ORGANIZATIONLocation/Facility of Arrest
ORGANIZATIONK SAM
ORGANIZATIONK Separation
ORGANIZATIONNew York State Division of Criminal Justice Services
ORGANIZATIONMedical Insurance Information
ORGANIZATIONFederal Bureau of Investigation - New York
ORGANIZATIONBROADWAY FBI NY
ORGANIZATIONLong Term Medical Conditions
ORGANIZATIONK Current
ORGANIZATIONK Eligible
ORGANIZATIONK Medical
ORGANIZATIONLeon Black
PERSONPrisoner Medical Records Release Form)-
ORGANIZATION
Julie K. Brown
PERSONAlbany
LOCATION