t Race ( heck) B M A / F Se (Check) fr e Register Number 3 /e OCI Middled ..-/44t±t i Ethnic Origin (Check) Hispanic or Other I C D O.B. Apecr FBI: INS: Other: CHARGES ECK ATEGORY OF CHARGES(S): FELONY MISDEMEANOR CIVIL CONTEMPT MATERIAL WITNESS ___ OTHER NARRATIVE4f2 /