BP-A0348 ADMINISTRATIVE DETENTION ORDER U.S. DEPARTMENT OF JUSTICE
JAN17 FEDERAL BUREAU OF PRISONS
NEW YORK MCC
Inslibton
Date/Time: 07-29-2019 12:21
TO: Sp IH nil UnitOfficer
FROM: IEUTENANT (Nameftitte)
EPSTEIN. JEFFREY EDWARD Reg. No 78318-054 in Administrabve Detention
SUBJECT: Placement°,
✓ (a) Is pending an investigation for a violation of Bureau regulations:
(b) Is pending an SIS investigation.
(c) Is pending investigation or trial for a criminal act;
(d) Is lobe admitted to Administrative Detention
(1) Since the inmate has requested admission (or protection;
I hereby request placement in Administrative Detention for my own protection.
Inmate Signature/Register No.:
Staff Witness Printed NameSignature:
admission; referral of
(2) Since a serious threat exists to individual's safety as perceived by staff, although person has not requested
the necessary Information will be forwarded for an appropriate hearing by the SRO.
(e) Is pending transferor is In holdover status during transfer.
(0 Is pending classification; or
(9) Is terminating confinement in Disciplinary Segregation and has been ordered into Administrative Detention by the Warden's
designee.
continued presence in the general
II is this Correctional Supervisors decision based on all the circumstances that the above named ni mate's
institution because'
population poses a serious threat to Me. property, self, staff, other inmates. or to the security or orderly running of the
PENDING UDC FOR CODE 228 SELF-MUTILATION
copy of this Order on
Therefore, the above named Inmate is to be placed in Administrative Detention until further notice. The Inmate received a
(date! time)
Staff Witness Signature/PrintedName Date
Supervisor 24 hour review of placement: Signature/Printed name
and decision, which Is
In the case of DHO action, reference to that Order Is outfitted In other cases. the Correctional supervisor will make an independent review
documented here.
Manager, Copy • Operation Supervisor
Record Copy - Inmate Concerned (not necessary if placement is a result of holdover status); Copy Captain; Copy • Unit
- Administrative Detention Unit; Copy — Psychology; Copy • Central File
POF Prescribed by P5270 (Replaces BP-A0308 of JAN 88.)
CONFIDENTIAL SDNY_00009518
EFTA00033865