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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
ECK ATEGORY OF CHARGES(S): FELONY MISDEMEANOR CIVIL CONTEMPT MATERIAL WITNESS ,!4;ipti (Check) Ethnic Origin (Check) Hispanic or Other D O.B. 00/C3 P FBI: INS: Other: OTHER Nil ARRATIVT, USC: 37/ Beg -77.4.0-Sidi coArsfiheifc/ T e: , NARRATIVE° Title: Air DSC:all/6i)/ a) (-2) Se
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
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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
Race __B FirstT ep „... ile/ Register Number , P-763 Ofi Middlefr„...44et i I C T R E ( heck) 411 W Se (Check) Ethnic Origin (Check) D O.B. FBI: __A __I __ _Hispanic or _Other //le/43' INS: Other: CHARGES GSF ,GATEGORY OF CHARGES(S): FELONY MISDEMEANOR CIVIL CONTEMPT MATERIAL
Entities connected to both Marshals Service and D O.B.

Jeffrey Epstein
PERSON
Department of Justice
ORGANIZATIONSouthern District
LOCATIONOPTIONAL
ORGANIZATIONControl as Remanding Receipt
ORGANIZATIONPrisoner Services Division
ORGANIZATIONthe Office of Interagency Medical Services
ORGANIZATIONLeon Black
PERSONREMANDS
ORGANIZATIONUnited States Marshals Service
ORGANIZATIONUSMS 312
ORGANIZATION
George W. Bush
PERSONNO PROPERTY NO PROPERTY NO
ORGANIZATIONCopy of Complaint
ORGANIZATIONBirth SSN
PERSONArrestee
ORGANIZATIONAttache
ORGANIZATIONDistrict File
ORGANIZATION