4
Shared Docs
4
Same-Page
4 / 4
Mentions
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
ion HI must be signed by the prisoner. If prisoner 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. Prisone
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
t Section HI must be signed by the prisoner. If prisoner reuses to sign, note that in the signalize block. An who& should be immediately repotted to the Office of Interagency Medical Services. Prisoner Services Division. The completed LISM form 552 is to be retained in the prisoners files. Section I -1.1SMS Prisoner Information I. Priso
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
on III must be signed by the prisoner. If prisoner 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 USM form 552 is to be retained in the prisoner's files. Section 1 - USMS Prisoner Information I. Prison
our arrester-, as you are the responsible party. United States Marshals Service Policy and Procedure: Manual 5.1-1.(a) EFTA01699630 ‘mccou states Marshals Service (USMSI PRISONER MEDICAL RECORDS RELEASE FORM svavo ; I, iV U completed by the USMS intake OfFiCCT. Sections ii It Hi arc to be completed by the pr
on III must be signed by the prisoner. If prisoner 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 USM form 552 is to be retained in the prisoner's files. Section I - USMS Prisoner Information I. Prison
Entities connected to both Marshals Service and the Office of Interagency Medical Services

Department of Justice
ORGANIZATION
Jeffrey Epstein
PERSONPrisoner Services Division
ORGANIZATIONSouthern District
LOCATIONControl as Remanding Receipt
ORGANIZATIONOPTIONAL
ORGANIZATIONUnited States Marshals Service
ORGANIZATIONLeon Black
PERSONNO PROPERTY NO PROPERTY NO
ORGANIZATION
United States
LOCATIONCopy of Complaint
ORGANIZATIONDistrict File
ORGANIZATIONUSMS 312
ORGANIZATIOND O.B.
ORGANIZATION
George W. Bush
PERSONREMANDS
ORGANIZATIONBirth SSN
PERSONthe United States Marshals Service
ORGANIZATIONAttache
ORGANIZATIONPrisoner Medical Records Release Form
ORGANIZATION