Epstein Secrets

N LH I. \ •1'• License Number License State \W.( I I.1 \\I 1)1 • \I ‘1111 lAticcellancous Number

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

ten SaserSigaatve of Receising 0 trieer: I base ,W.> reviessd proiSrt> rerorned mr mie Mina ins of

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 USM loan 552 is to be retained in the prisoner's files. Section I - USMS Prisoner Information 1. Prisoner Name (Last. First MI) 2.

ltuctis Soodl Suva pooh —r r•Short ...... S.W.* Shirt Thermal Seem — DU/nu' fop —r. / Under

soner refuses to sign, note that in the signature block. Al! refusals should he 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. Prisoner Name (Last. Fite. 5714/