LAW ENFORCEMENT SENSMVI? .S. Department of Justice Unitial States Marshals Sen ice Personal History of Defendant Taken • to Federal custody by the folio% lag: Street Arrest (not from a correctional detention facility) O Custodial Arrest (from a correctionaLdmention facility) eriii Used (Must provide cop) of wit) Atir Ce4 r ‘'-+c'C04..--r- 0 Priur Federal Attest or Salikeeper • Register r': • O Sofekeeper Location: Itl y.0 \rim INFORM vrios Last Narae: ,C7:60A/ I First Name: at,/ e Middle Name: edmi ted Sex: r K Transgender Pregnant: O Y Race: yf Afert DUB: /-21/1-:" 70, C Rain 6 Eyes: 49,4,4C Height: C Weight City of Birth: 4, State/Coun ry of Birth: 4/ Citizenship FBI N: State IDN: Alien : SSN: Resident Address/City/StaleTZIP: 9 a;„7.,Air , llome Phone Cell Phone: ell It I \NI Agt.er NY /en' Agent Phone N: Location/Facility of Arrest: Court Docket it: •e-trVOICKi AUSA(s) Assigned: /OO tat Status; Agency ORE OF FENN' Nr'IC Code barge Description ..SeYreAtenCfrinti 495( us(: 37/ kease DetainersAVarranit: ' QY. Agency: INIaai amide a rap, area, detainer%) {CM I \ l••• %ND NII DI( %I. Long Term Medical Conditions Aran problcass.dialwitt. asthma. tuberculosis. I111'. etc.): O I( Payetsfatinc/EnintiOnally Disturbed lea.. wand health cowrie.. wieldst. N O N. Injuries/Medical Ailments/Post-Op Recovery:* O Do the above conditions ref) re: Medical attention? Medication? N ❑V N Title/Code %Wifel clearance by a hemmed physician: ION O Is Defendant under the influenceof drugs or alcohol: IAN O Languages - English: ars, litc- Limited , Other Language: N - List: Security Cautions: C rrcnt or former military or tanner public official ligible for diplomatic immunity O Threat to witness kscribe &shoe) O Current or former 1.1 correction O Assault on LE COnteliOnS O Leadership role K ci (IA:scribe helm) U.LES l'atte I of) El Current or fanner intelligence O SAM subject or candidate O Sep