EPORT J.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS I Institution MCC New York 2. inmate's Name: Epstein Jeffery 9. Place of Incident: SHU M-Tier Cell 124 9. Modern. Self-Mutilation Part I — Incident Report Incident Report fftitabe 3. Register Number. 4. Dale of lnddem: 76318-054 07/23/2019

REPORT J.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 1 Institution MCC New York 2. Inmate's Name: Epstein Jeffery b. Mace of Incident: SHU M-Tier Cell 124 9. In ent Self-Mutilation 3 Register Number: 76318-054 7. Assignment: Unassigned - I Part I ncident rt Repo ralent Report Numbe 4. Date

rt Numbets5_3ip 4. Date of Indent: ?TimB 07123/2019 1:27am 2. Inmate's Name: Epstein Jeffery 3. Register Number 76318-054 6. Place oftnadent SHU M-Tier Cell 124 —T. Assignment: Unassigned S. una ZA 9. Incident Self-Mutilation 10. Prohibited Act Code (s): 228 11. Description of Incident (Date: 07/23

2. Inmate's-Name: Epstein . Jeffery 3. Register Number: 76318-054 4. Date of Incitenl: j 07/23/2019 5. Time: 1:27am 6. Place of Incident. SHU M-Tier Cell 124 7. Assignment: Unassigned 8. U ZA 9. Incident: Self-Mutilation 10. Prohibited Ad Code (a): 228 11. Description of incident (Date: 07/23/201

MENT OF JUSTICE INCIDENT REPORT FEDERAL BUREAU OF PRISONS I. Institution' • MCC New York 2Tmate's Name: Epstein Jeffery B. Place of Incident: SHU M-Tier Cell 124 9. Indent: Self-Mutilation . Part I — Incident Report Incident Report Numbe 3. Register Number. . a o o ent: 76318-054 07/23/2019 1:27a

Nunfintal..3 Cy 2. Inmate's Name: Epstein . Jeffery 3. Register Number 16318-054 4. Date of Incident: 07/23/2019 1:27am 6. Place oflnadent: SHU M-Tier Cell 124 7. Assignment: Unassigned B. Un ZA • 9. Incident Sell-Mutilation . 1-0. Prohibited Act Code (s): 228 11. Description of Incident (Date:

2. Inmate's Name: Epstein . Jeffery 3. Register Number. 76318-054 4. Date of Incident: 07/23/2019 37a tC r . 1:27am ' S. Place of Incident: SHU M-Tier Cell 124 7. Assignment: Unassigned a. Unit ZA 9. Incident: Sell-Mutilation . to RolulitecTAct Code (s). 228 11. Description of Incident (Date: 07

. 2. Inmate's Name: Epstein . Jeffery 3. Register Number: 76318-054 4. Date of incident j 07/23/2019 5. Time: 1:27am S. Place of Incident: SHU M-Tier Cell 124 1. Assignment: Unassigned 8. V ZA 9. Incident: Self-Mutilation 10. Prohibited Act Code (a): 228 11. Description of incident (Date: 07/23/2

2of 2 Page 1057 ' ' .. BP-, 1021!8' JAN,1F INCIDENT REPORT U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS . 1me: 1:27am 1gnmen : SHU M-Tier Cell 124 Unassigned 11. Description of Incident (Date: 07/23/2019 Time: 1 :27 AM Staff became aware of Incident): (b)(7)(A) (b)(6); f b)(6); (b)(7)

e2of 2 Page 1140 ' ' .. BP-, 1021!8' JAN,1F INCIDENT REPORT U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS . 1me: 1:27am 1gnmen: SHU M-Tier Cell 124 Unassigned ent: Self-Mutilation .b)(7)(A) 17. Comments of Inmate to Committee Regarding Above Incident: u.las c WV h~ s r",ai,.\s c1n& I :

um 2. Inmate's Name Epstein . Jeffery 3. Register Number: 76318-054 4. Date of Incident 07/23/2019 11:27am 57aP5c5 : 6. Place of Incident: SHU M-Tier Cell 124 7. Assignment: Unassigned 8. U ZA 9. Incident Self-Mutilation . Prohibited Act Code (sr 228 11. Description of incident (Date: 07/23/2019

umbet>3 ir;; .ca 2. Inmate's Name: Epstein Jeffery 3. Register Number 76318-054 4. Date of Incident: 07/23/2019 1:27am 6. Place of Incident: SHU M-Tier Cell 124 7. Assignment Unassigned a. Unit ZA a ulf- ent. Self-Mutilation . 0. Pro Deed Act Code (5): 228 11. Description of Incident (Date: 07/23/2

Date of Incident: 07/23/2019 (Q c--t cz5 ci rut 1:27am 2. Inmate's Name: Epstein , Jeffery Register Number: 76318-054 b. Place of Incident: SHU M-Tier Cell 124 7. Assignment: Unassigned 8. Unit ZA Tir dla " I: Self-Mutilation 10. ro r to o ode (5): 228 11. Description of Incident (Date: 07/23/20

I 7 7 2. Inmate's Name: Epstein Jeffery 3. Register Number: 76318.054 4. Date of Incident: 07/23/2019 5: a; 1:27am 8. Place of Incident: SHU M-Tier Cell 124 7. Assignment: Unassigned 5. Unit ZA 9. Incident: Sell-Mutilation 10. Prohibited Ad Code (s): 228 11. Description of Incident (Date: 07/23/

• (t' 4;i 5.754 1:27am 2. Inmates Name. Epstein , Jeffery 3. Register Number 76318-054 4. Date of Incident. 07/23/2019 6. Place of Incident: SHU M-Tier Cell 124 /. Assignment B. Uni: Unassigned ZA 1:17raent Self-Mutilation I 10. Prohibited Act Code (s) 228 11. Description of Incident (Date: 0723201

n itenber aisc ea, nr rn m”. tlems: Epstein . Jeffery 3 Register Number 76318-054 4 Date of-Diadem 07/23/2019 57 new. 1:27am B Place of rodent SHU M-Tier Cell 124 7. Assganeflt Unassigned 5. ZA sea4aottaaon 10 Prohibited Ad Code (*). 228 11. DesulPhon of in dent (Date: 07/23/2019 time. 1:27AM Stan m

DENT REPORT J.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS instrtueco MCC New York 2 Inmate 'Mame: Epstein . Jeffery 8 mace of Incident: SHU M-Tier Cell 124 9. Incident Sell-Mutilation Part I - Incidant Report Incident Report Numbet--13.9 45 act,c5ek Inadenk 3 Register Number 4. DM* of 76318-054