BP-A0377

APR 10

PRISONER REMAND

CDFRM

U.S. DEPARTMENT OF JUSTICE

FEDERAL BUREAU OF PRISONS

ARRESTING OFFICER WILL COMPLETE ALL REQUIRED DATA

ON THIS FORM PRIOR TO COMMITTING TO MCC/MDCs.

Register Number

Name: Last

Middle

First

AKAs:
Race (Check)

Sex (Check)

Ethnic Origin (Check)

__B __W __A __I

__M __F

__Hispanic or __Other

CHARGES
CHECK CATEGORY OF CHARGES(S):
_____ FELONY
_____ MISDEMEANOR

D.O.B.

SSN:

______ CIVIL CONTEMPT

FBI:
INS:
Other:

______ MATERIAL WITNESS

OTHER
NARRATIVE:
Title:
NARRATIVE:
Title:

USC:
USC:

Date of Offense:

Date of Arrest:

State of Birth

Country of Birth

Height
Ft:

Weight

In:

Hair

Citizenship

Eyes

Sentenced
__Y
__N

IN

Current Address

Zip Code

Scars / Marks / Tattoos

Injuries / Medication

Arraigned
__Y
__N

Place of Arrest:

Emergency Contact:(Name, Address, Phone

Number)

Special Handling: __Y or __N

Remarks:
IN

Remanding Official (Name)

Sign

IN
Agency/District

IN

IN

Phone/24 Hour Number

Print
OUT

OUT

Removing Official (Name)

Sign

OUT
Agency/District

OUT

OUT

Phone/24 Hour Number

Print

FOR BOP USE ONLY

Receiving Official (Name)
Sign
Print

Date / Time

Releasing Official (Name)

Sign

Date / Time

Print

Sentry Load Data: (Must Initial)

Name Search Completed by:
Clearance/Separate Checked by:

(OPTIONAL USE)
ARS Code
Staff Init.
Add AKAs
Create Cash Account
Deposit Cash
Amt.
Detainers
Court
Clothing Bag #

RIGHT THUMBPRINT

Original-for ISM as Remanding-Removal receipt; Copy-for Control as Removal Receipt (NCIC); Copy-For
Removing Official; Copy-for Control as Remanding Receipt (Inmate); Copy-INS-Alien in Custody.
PDF

Prescribed by P5800
This form replaces BP-S377(58) and BP-377(58) of JUL 91