A0298 N.17 J.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS INCIDENT REPORT Part I - Incident Report 1. Institution: MCC New York 2. Inmate's Name: Epstein, Jeffery 3. Register Number: 76318-054 4. Date of Incident: 07/23/2019 5. Time: 1:27am 6. Place of Incident: SHU M-Tier Cell 124 7. Assignment: Unassigned 8. Unit: ZA 9. Incident: Self-Mutilation 10. Prohibited Act Code (s): 228 Incident Report Number: 3282555 (b)(7)(A) (b)(6); (b)(7)(C) 12. Typed Name/Signature: (b)(6); (b)(7)(A); (b)(7)(C) 13. Date And Time: 07/23/2019 3:30am 14. Incident Report Delivered By (Type Name/Signature): 15. Date Incident Report Delivered: 16. Time Incident Report Delivered: Part II - Committee Action 17. Comments of Inmate to Committee Regarding Above Incident: 18. A. It is the finding of the committee that you: Committed the Prohibited Act as charged: Did not Commit a Prohibited Act. Committed Prohibited Act Code (s). B. The Committee is referring the Charge(s) to the DHO for further Hearing C. The Committee advised the inmate of its finding and of the right to file an appeal within 20 calendar days. 19. Committee Decision is Based on Specific Evidence as Follows: 20. Committee action and/or recommendation if referred to DHO (Contingent upon DHO finding inmate committed prohibited act): 21. Date and Time of Action: (The UDC Chairman=s signature certifies who sat on the UDC and that the completed report accurately reflects the UDC proceedings). Chairman (Typed Name/Signature): Member (Typed Name): Member (Typed Name): INSTRUCTIONS: All items outside of heavy rule are for staff use only. Begin entries with the number 1 and work up. Entries not completed will be voided by staff. Distribute: Original-Central File Record; COPY-1-DHO: COPY-2-Inmate after UDC Action; COPY 3-Inmate within 24 hours of Part I Preparation PDF Prescribed by P5270 Replaces BP-A0288 of AUG 11 COPY 7/17 (b)(6); (b)(7)(C) DOJ-OGR-00027207
Full Text
A0298 N.17 J.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS INCIDENT REPORT Part I - Incident Report 1. Institution: MCC New York 2. Inmate's Name: Epstein, Jeffery 3. Register Number: 76318-054 4. Date of Incident: 07/23/2019 5. Time: 1:27am 6. Place of Incident: SHU M-Tier Cell 124 7. Assignment: Unassigned 8. Unit: ZA 9. Incident: Self-Mutilation 10. Prohibited Act Code (s): 228 Incident Report Number: 3282555 (b)(7)(A) (b)(6); (b)(7)(C) 12. Typed Name/Signature: (b)(6); (b)(7)(A); (b)(7)(C) 13. Date And Time: 07/23/2019 3:30am 14. Incident Report Delivered By (Type Name/Signature): 15. Date Incident Report Delivered: 16. Time Incident Report Delivered: Part II - Committee Action 17. Comments of Inmate to Committee Regarding Above Incident: 18. A. It is the finding of the committee that you: Committed the Prohibited Act as charged: Did not Commit a Prohibited Act. Committed Prohibited Act Code (s). B. The Committee is referring the Charge(s) to the DHO for further Hearing C. The Committee advised the inmate of its finding and of the right to file an appeal within 20 calendar days. 19. Committee Decision is Based on Specific Evidence as Follows: 20. Committee action and/or recommendation if referred to DHO (Contingent upon DHO finding inmate committed prohibited act): 21. Date and Time of Action: (The UDC Chairman=s signature certifies who sat on the UDC and that the completed report accurately reflects the UDC proceedings). Chairman (Typed Name/Signature): Member (Typed Name): Member (Typed Name): INSTRUCTIONS: All items outside of heavy rule are for staff use only. Begin entries with the number 1 and work up. Entries not completed will be voided by staff. Distribute: Original-Central File Record; COPY-1-DHO: COPY-2-Inmate after UDC Action; COPY 3-Inmate within 24 hours of Part I Preparation PDF Prescribed by P5270 Replaces BP-A0288 of AUG 11 COPY 7/17 (b)(6); (b)(7)(C) DOJ-OGR-00027207
--- PAGE BREAK ---
NYMBN PAGE 001 OF 001 INMATE DISCIPLINE UPDATE CHARGES 07-30-2019 12:58:08 REGISTER NUMBER...: 76318-054 NAME.........: EPSTEIN REPORT NUMBER.....: 3282555 FUNCTION......: REP INCIDENT DATE/TIME: 07-23-2019 0127 INCIDENT FACL.: NYM REPORT DATE/TIME..: 07-30-2019 1240 INVESTIGATOR..: b(6); (b)(7)(C) STATUS............: PEND UDC STATUS UPDT BY: NYM STATUS DATE/TIME..: 07-30-2019 1256 STATUS FACL...: NYM REPORT REMARKS....( I/R UNSUSPENDED TO GO FOWARD WITH UDC PROCESS. ) CHARGE: 228 TATTOOING OR SELF-MUTILATION CHARGE: CHARGE: CHARGE: CHARGE: CHARGE: CHARGE: CHARGE: CHARGE: G0005 TRANSACTION SUCCESSFULLY COMPLETED - CONTINUE PROCESSING IF DESIRED Page 1 of 1 7/30/2019 DOJ-OGR-00025274
--- PAGE BREAK ---
Page 106
A0288
N.47
J.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
INCIDENT REPORT
Part I - Incident Report
1. Institution: MCC New York
2. Inmate's Name: Epstein, Jeffery
3. Register Number: 76318-054
4. Date of Incident: 07/23/2019
5. Time: 1:27am
6. Place of Incident: SHU M-Tier Cell 124
7. Assignment: Unassigned
8. Unit: ZA
9. Incident: Self-Mutilation
10. Prohibited Act Code (s): 228
Incident Report Number: 3282555
(b)(7)(A)
(b)(6); (b)(7)(C)
(b)(6); (b)(7)(C)
(b)(6); (b)(7)(C)
12. Typed Name/Signature:
14. Incident Report Delivered By (Type Name/Signature):
13. Date And Time: 07/23/2019 3:30am
15. Date Incident Report Delivered:
16. Time Incident Report Delivered:
Part II - Committee Action
17. Comments of Inmate to Committee Regarding Above Incident:
18. A. It is the finding of the committee that you:
Commited the Prohibited Act as charged:
Did not Commit a Prohibited Act.
Commited Prohibited Act Code (s).
B. The Committee is referring the Charge(s) to the DHO for further Hearing
C. The Committee advised the inmate of its finding and of the right to file an appeal within 20 calendar days.
19. Committee Decision is Based on Specific Evidence as Follows:
20. Committee action and/or recommendation if referred to DHO (Contingent upon DHO finding inmate committed prohibited act):
21. Date and Time of Action: (The UDC Chairman=s signature certifies who sat on the UDC and that the completed report accurately reflects the UDC proceedings).
Chairman (Typed Name/Signature):
Member (Typed Name):
Member (Typed Name):
INSTRUCTIONS: All items outside of heavy rule are for staff use only. Begin entries with the number 1 and work up. Entries not completed will be voided by staff.
Distribute: Original-Central File Record; COPY-1-DHO: COPY-2-Inmate after UDC Action; COPY 3-Inmate within 24 hours of Part I Preparation
PDF
Prescribed by P5270
Replaces BP-A0288 of AUG 11
COPY
(b)(6);
(b)(7)(C)
DOJ-OGR-00024720
--- PAGE BREAK ---
Page 273 A0288 N.47 INCIDENT REPORT J.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS Part I - Incident Report 1. Institution: MCC New York Incident Report Number: 3282555 2. Inmate's Name: Epstein, Jeffery 3. Register Number: 76318-054 4. Date of Incident: 07/23/2019 5. Time: 1:27am 6. Place of Incident: SHU M-Tier Cell 124 7. Assignment: Unassigned 8. Unit: ZA 9. Incident: Self-Mutilation 10. Prohibited Act Code (s): 228 (b)(7)(A) 12. Typed Name/Sig (b)(6); (b)(7)(C) 13. Date And Time: 07/23/2019 3:30am 14. Incident Report Delivered By (Type Name/Signature): (b)(6); (b)(7)(C) 15. Date Incident Report Delivered: 16. Time Incident Report Delivered: Part II - Committee Action 17. Comments of Inmate to Committee Regarding Above Incident: 18. A. It is the finding of the committee that you: Committed the Prohibited Act as charged: Did not Commit a Prohibited Act. Committed Prohibited Act Code (s). B. The Committee is referring the Charge(s) to the DHO for further Hearing C. The Committee advised the inmate of its finding and of the right to file an appeal within 20 calendar days. 19. Committee Decision is Based on Specific Evidence as Follows: 20. Committee action and/or recommendation if referred to DHO (Contingent upon DHO finding inmate committed prohibited act): 21. Date and Time of Action: (The UDC Chairman=s signature certifies who sat on the UDC and that the completed report accurately reflects the UDC proceedings). Chairman (Typed Name/Signature): Member (Typed Name): Member (Typed Name): INSTRUCTIONS: All items outside of heavy rule are for staff use only. Begin entries with the number 1 and work up. Entries not completed will be voided by staff. Distribute: Original-Central File Record; COPY-1-DHO: COPY-2-Inmate after UDC Action; COPY 3-Inmate within 24 hours of Part I Preparation PDF Prescribed by P5270 Replaces BP-A0288 of AUG 11 COPY b6(b)(7)(C) DOJ-OGR-00024812
Individual Pages
Page 1 - DOJ-OGR-00027207
Page 1 - DOJ-OGR-00025274
NYMBN PAGE 001 OF 001 INMATE DISCIPLINE UPDATE CHARGES 07-30-2019 12:58:08 REGISTER NUMBER...: 76318-054 NAME.........: EPSTEIN REPORT NUMBER.....: 3282555 FUNCTION......: REP INCIDENT DATE/TIME: 07-23-2019 0127 INCIDENT FACL.: NYM REPORT DATE/TIME..: 07-30-2019 1240 INVESTIGATOR..: b(6); (b)(7)(C) STATUS............: PEND UDC STATUS UPDT BY: NYM STATUS DATE/TIME..: 07-30-2019 1256 STATUS FACL...: NYM REPORT REMARKS....( I/R UNSUSPENDED TO GO FOWARD WITH UDC PROCESS. ) CHARGE: 228 TATTOOING OR SELF-MUTILATION CHARGE: CHARGE: CHARGE: CHARGE: CHARGE: CHARGE: CHARGE: CHARGE: G0005 TRANSACTION SUCCESSFULLY COMPLETED - CONTINUE PROCESSING IF DESIRED Page 1 of 1 7/30/2019 DOJ-OGR-00025274
Page 106 - DOJ-OGR-00024720
Page 106
A0288
N.47
J.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS
INCIDENT REPORT
Part I - Incident Report
1. Institution: MCC New York
2. Inmate's Name: Epstein, Jeffery
3. Register Number: 76318-054
4. Date of Incident: 07/23/2019
5. Time: 1:27am
6. Place of Incident: SHU M-Tier Cell 124
7. Assignment: Unassigned
8. Unit: ZA
9. Incident: Self-Mutilation
10. Prohibited Act Code (s): 228
Incident Report Number: 3282555
(b)(7)(A)
(b)(6); (b)(7)(C)
(b)(6); (b)(7)(C)
(b)(6); (b)(7)(C)
12. Typed Name/Signature:
14. Incident Report Delivered By (Type Name/Signature):
13. Date And Time: 07/23/2019 3:30am
15. Date Incident Report Delivered:
16. Time Incident Report Delivered:
Part II - Committee Action
17. Comments of Inmate to Committee Regarding Above Incident:
18. A. It is the finding of the committee that you:
Commited the Prohibited Act as charged:
Did not Commit a Prohibited Act.
Commited Prohibited Act Code (s).
B. The Committee is referring the Charge(s) to the DHO for further Hearing
C. The Committee advised the inmate of its finding and of the right to file an appeal within 20 calendar days.
19. Committee Decision is Based on Specific Evidence as Follows:
20. Committee action and/or recommendation if referred to DHO (Contingent upon DHO finding inmate committed prohibited act):
21. Date and Time of Action: (The UDC Chairman=s signature certifies who sat on the UDC and that the completed report accurately reflects the UDC proceedings).
Chairman (Typed Name/Signature):
Member (Typed Name):
Member (Typed Name):
INSTRUCTIONS: All items outside of heavy rule are for staff use only. Begin entries with the number 1 and work up. Entries not completed will be voided by staff.
Distribute: Original-Central File Record; COPY-1-DHO: COPY-2-Inmate after UDC Action; COPY 3-Inmate within 24 hours of Part I Preparation
PDF
Prescribed by P5270
Replaces BP-A0288 of AUG 11
COPY
(b)(6);
(b)(7)(C)
DOJ-OGR-00024720
Page 273 - DOJ-OGR-00024812
Page 273 A0288 N.47 INCIDENT REPORT J.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS Part I - Incident Report 1. Institution: MCC New York Incident Report Number: 3282555 2. Inmate's Name: Epstein, Jeffery 3. Register Number: 76318-054 4. Date of Incident: 07/23/2019 5. Time: 1:27am 6. Place of Incident: SHU M-Tier Cell 124 7. Assignment: Unassigned 8. Unit: ZA 9. Incident: Self-Mutilation 10. Prohibited Act Code (s): 228 (b)(7)(A) 12. Typed Name/Sig (b)(6); (b)(7)(C) 13. Date And Time: 07/23/2019 3:30am 14. Incident Report Delivered By (Type Name/Signature): (b)(6); (b)(7)(C) 15. Date Incident Report Delivered: 16. Time Incident Report Delivered: Part II - Committee Action 17. Comments of Inmate to Committee Regarding Above Incident: 18. A. It is the finding of the committee that you: Committed the Prohibited Act as charged: Did not Commit a Prohibited Act. Committed Prohibited Act Code (s). B. The Committee is referring the Charge(s) to the DHO for further Hearing C. The Committee advised the inmate of its finding and of the right to file an appeal within 20 calendar days. 19. Committee Decision is Based on Specific Evidence as Follows: 20. Committee action and/or recommendation if referred to DHO (Contingent upon DHO finding inmate committed prohibited act): 21. Date and Time of Action: (The UDC Chairman=s signature certifies who sat on the UDC and that the completed report accurately reflects the UDC proceedings). Chairman (Typed Name/Signature): Member (Typed Name): Member (Typed Name): INSTRUCTIONS: All items outside of heavy rule are for staff use only. Begin entries with the number 1 and work up. Entries not completed will be voided by staff. Distribute: Original-Central File Record; COPY-1-DHO: COPY-2-Inmate after UDC Action; COPY 3-Inmate within 24 hours of Part I Preparation PDF Prescribed by P5270 Replaces BP-A0288 of AUG 11 COPY b6(b)(7)(C) DOJ-OGR-00024812