13P.AnCia JAN 17 ADMINISTRATIVE DETENTION ORDER U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS TO: Special H ng Unit Officer FROM: SUBJECT: Placement of EPSTEIN. JEFFREY EDWARD (Name/rite) Reg. No. (a) Is pending an investigation for a vrolation of Bureau regulations: (b) Is pending an SIS investigation. (c) Is pending investigation or trial for a cnminal act: (d) Is to be admitted to Administrative Detention (1) Since the inmate has requested admission for protection; NEW YORK MCC instsition Date/Time- 07-29.2019 12-.21 76318-054 in Administrative Detention I hereby request placement in Administrative Detention for my own protection. Inmate Signature/Register No.: Staff Witness Printed Name Signature: (2) Since a serious threat exists to individual's safety as perceived by staff, although person has not requested admission; referral of the necessary information wit be forwarded for an appropriate hearing by the SRO. (e) Is pending transferor is in holdover status during transfer (f) is pending classificatory or (9) Is terminating confinement In Disciplinary Segregation and has been ordered Into Administrative Detention by the Warden's designee. II is the Correctional SupenAsor's decision based on all the circumstances that the above named Inmate's continued presence in the general population poses a serious throat lo !de. property, self, staff, other inmates. or to the security or orderly running of the institution because' PENDING UDC FOR CODE 228 SELF-MUTILATION Therefore, the above named Inmate is to be placed in Administrative Detention unti further notice. The Inmate received a copy of this Order on (date / time) Staff Witness Signature/Printed Name Date Supervisor 24 hour review of placement: Signature/Printed name • In the case of DHO action, reference to that order is sufficient. In other cases, the Correctional supervisor will make an independent review and decision. which I documented here. Rec