郭文贵刑事案 · EXHIBIT · ECF #81-13

元数据

当事人: 郭文贵 (Guo Wengui / Miles Guo / Ho Wan Kwok)
法院: SDNY
案号: 23-cr-00118
ECF #: 81
类型: EXHIBIT
立案日: 2023-06-05

原始法庭文件为英文，下方为英文全文。

全文

# EXHIBIT K

*United States v. Yanping Wang*, Case No.: S1 23-CR-118 (AT)

# Worksheet for Pretrial Services Report

| PACTS Client ID No.: | | Cir/Dist/Docket/Defendant No: | 31 | Arrest Date: | | |-----------------------|------------------|-------------------------------|----------|--------------|--| | Interviewing Officer: | Jessica Aguilar. | Interview Date: | 3/15/23. | | |

CLIENT PERSONAL DATA - General

| Prefix: | | Title: (Dr., PhD., etc.) | | | | | | |-------------------------|---------|---------------------------|--|---------------------------------------|------|------------|--| | Court Name: First | Yanping | Middle | | Last | Wang | Generation | | | SSN/EIN: | | State Identification No.: | | FBI No.: | | | | | Register/Marshal's No.: | | ICE (INS) No.: | | Driver's License No.: (Include state) | | | |

CLIENT PERSONAL DATA - Alternate Names and Ids (If more than four, attach list)

| First | Middle | Last | Generation | | | |------------------------------------------------------------------------------------------------------------------------------------------|--------|------|------------|--------------------------------------|----------------------------------| | Evelyn | | | | [X] Also Known [ ] Alternate Name | [ ] Maiden Name [ ] True Name | | | | | | [ ] Also Known [ ] Alternate Name | [ ] Maiden Name [ ] True Name | | | | | | [ ] Also Known [ ] Alternate Name | [ ] Maiden Name [ ] True Name | | Alternate IDs: (List any other alien numbers, state ID numbers, SSNs, DOBs) 2 friends from China. Wayne, Tao Cao. yes. Bond cosigned. | | | | | | | Distinguishing Characteristics: (Scars, tattoos, etc.) 212 826 8882. card. Royat | | | | | |

CLIENT PERSONAL DATA - Demographics

| Sex: (Check one) | Race: (Check one) | Hispanic: (Check one) | Eye Color: | Height: | Weight: | |------------------|-----------------------------------------------|-----------------------|----------------------|-----------------|---------------------------| | [X] Female | [ ] American Indian or Alaska Native | [ ] Hispanic | [ ] Blue | 5' 1" | 140 | | [ ] Male | [X] Asian | [X] Non-Hispanic | [X] Brown | Age: (Redacted) | Date of Birth: (Redacted) | | [ ] Unknown | [ ] Black or African American | [ ] Unknown | [ ] Green | Hair Color: | | | | [ ] Native Hawaiian or Other Pacific Islander | | [X] Hazel | [X] Black | [ ] Blonde | | | [ ] Other Race | | [ ] Other | [ ] Brown | [ ] Grey | | | [ ] Unknown | | Written: Black/Brown | [ ] None | [ ] Other | | | [ ] White | | | [ ] Red | [ ] White |

| Place of Birth: | (Redacted) | Country of: | (Redacted) | |----------------------------------------------------|-----------------|--------------------------------------|-------------------------------| | Citizenship: (Check one) | | Additional Citizen Information: | | | [X] Citizen of Another Country | | [X] Permanent Resident [ ] Refugee | | | [ ] U.S. Citizen [ ] Naturalized US Citizen | | [ ] Temporary Visa [ ] Illegal Alien | | | [ ] U.S. National [ ] Unknown | | [ ] Unknown | | | Do you possess a passport/visa? | [X] Yes [ ] No | Location: | FBI seized. Chinese passport. | | Country of Citizenship: | China. | Date Naturalized: | | | | | | Pending approval. Asylum. | | Have you traveled outside the U.S.? [X] Yes [ ] No | | | | | Countries: | | Purpose: | | | Date Immigrated to the United States: | April/May 2017. | Date Entered United States: | |

CLIENT PERSONAL DATA - Remarks

Singapore, Hong Kong, Europe, England, France. Before 2017.

PS2 (Rev. 10/09)

| 124 (Rev. 10/09) |-----------------------------------------------------------------------| | | | City: | Address Type: Residence Legal Address | C Mailing Address | Defendant Lives With? | Name on Lease/Mortgage; P 0 | Have you ever lived outside the state/country? O Yes O No Explain: | | Other/Prior Residences | 2 an | | | (Check box if living with defendant) | Name/Age | | | | 0 | | 0 | 0 | 0 | 0 | | | | | | | | 10801 | | | --------|--------------------------------------------------------------------------------------------------------------------------|------------------|--------------------|--------------------------------------------------------------------|------------|-----------------------------|---------------------------------------------------------------------------------------------|--|--| | | CLIENT PERSONAL DATA - Addresses | | | | | | | | | | | | | | Phone (Residence): | | | Phone (Mobile): | | | | State: | | | | County: | | | Phone (Pager/Fax): | | | | | Date Moved to This Address (From Date): E-Mail: Time in Community of Residence: DAYS / MONTHS / YEARS (circle one) | | | | | | | | | | | 2020 | - Begin. 2017 | | | | | | | | | 11000 | | | | | | | | | | | | IC. | | Name on Utilities: | | | | Monthly Payment; | | | | | | | Do you own any firearms? Are there any firearms where you live? | | | ONO O Yes O Yes DNO Any dogs or dangerous animals where you live? [ Yes D-No | | | | | Start Date | | End Date | | With Whom? | | | | | | | Since 2017 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | CLIENT PERSONAL DATA - Collateral Contacts (Family, Friends, Other Frequent Contacts, etc.) | | | | | | | | | | | Relationship/Frequency of Contact | | | Citizenship Status | | Address and Phone Number | Miscellaneous Notes/ Occupation | | | | CM | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | out | | | | | | | | | Not | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |

PS2 (Rev. 10/09)

(Rev. 10/09)**MARITAL HISTORY (Including cohabitation)**

(Check box if living with defendant)

| Current Marital Status: (Current Personal Data/Profile) | [ ] Cohabitating [X] Divorced [ ] Married [ ] Separated [ ] Single [ ] Widowed [ ] Unknown | |---------------------------------------------------------|--------------------------------------------------------------------------------------------| |---------------------------------------------------------|--------------------------------------------------------------------------------------------|

| Name | Marital Status | Citizenship | Address/Telephone No. | Dates of Marriage | No. of Children | |--------------|----------------|-------------|-----------------------|-------------------|-----------------| | [ ] Current: | | | | 2 3 years ago. - | | | | | | 2006 - | | | | | | | | | | | | | | | | |

**CHILDREN**

(Check box if living with defendant)

| Name/Age of Children | Children Live With Whom? | Citizenship | Address/Telephone No. | Frequency of Contact | Support? | |----------------------|--------------------------|-------------|-----------------------|--------------------------------------------|----------| | [ ] Son (10) | China - w/ exhusband. | | | 2018-detained family no contact since then | | | [ ] | | | | | | | [ ] | | | | | | | [ ] | | | | | |

| EDUCATION | | MILITARY HISTORY | | |-------------------------------------------------|---------------------------------------------|------------------------------------|----------------| | Education Level: (Client Personal Data/Profile) | | Branch of Service: | | | [ ] No High School Diploma/GED | [ ] Associate's Degree [ ] Unknown | Dates of Service: | | | [ ] Graduate Equivalency | [ ] Bachelor's Degree [ ] Some College | Type of Discharge: | | | [ ] Vocational/Apprentice Graduate | [X] Master's Degree | Were you court-martialed? | [ ] Yes [ ] No | | [ ] High School Diploma | [ ] Doctorate | Was any disciplinary action taken? | | | Date Education Obtained/Last Year Attended: | 2005, 2007. - in china. | | | | Name/Location of Current School: | | | | | Grade Completed: | | | | | Certificates/Degrees: | American Chinese Politics Culture, History. | | |

| English Language Skills: (Client Personal Data/Profile) | | |---------------------------------------------------------|-----------------------------------------------------------------| | [ ] Fluent in English as Primary Language | [X] Mute - Fluent in International Sign Language | | [ ] Fluent in English as Secondary Language | [ ] Mute - Limited or No Fluency in International Sign Language | | [ ] Limited Fluency in English | [ ] Unknown | | [ ] No Fluency in English | Primary Language (if not English) | | Primary language - Chinese. | |

PS2 (Rev 10/09)

| | | | Current Employment / Unemployment (Client Personal Data) | | | | | | |-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------|------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------|--|--|--| | Is the defendant currently employed? O Yes If No, skip to unemployment section below | | O No | Company Name: nemblo | | O Self-Employed? Sep 1. 1947 202 | | | | | Address: (Street) | | | City: State: | Zip Code: | County: | | | | | Start Date: | Hours Per Week: | | Phone No .: | | | | | | | Occupation: | | | | Gross Income for This Employment: | | | | | | Job Title: | | | સ્ત્રે | Hourly Semi-Monthly Weekly Monthly I | | | | | | How Long Employed? | Work Hours: | | | Biweekly | Yearly | | | | | Can you return to your job? | | | Does your employer know about your arrest? | O Yes | D No | | | | | O Yes O No | O Unknown | | Can your employer be contacted? | O Yes D No | | | | | | Supervisor's Name: | Supervisor's Title: | | Supervisor's Phone No .: | Supervisor's Cell/Pager No .: | | | | | | | | | ** UNEMPLOYMENT DATA** | | | | | | | Unemployment Start Date: | | | If unemployed, reason for unemployment/reasons for leaving is required | | | | | | | Reasons for Unemployment: | | | Reasons for Leaving: | | | | | | | C Caregiver D Court Order 0 0 Disabled E O Other: Homemaker Looking for Work (Code as not excused in PACTS) | Long-Term Treatment Retired Student | | Position Ended Arrested Fired for Misconduct O Retired Fired Poor Performance Unknown Q Quit w/Out Job Arranged Incarcerated I Started Full Time Educ/Vocational Laid Off Moved Residence Other E L | | | | | | | Vocational/Training Skills: (Check all that apply) (Client Personal Data/Profile) O Finance O Architecture and Engineering O Arts, Design, Entertainment and Media O Healthcare O Child/Adult Care C Community and Social Services Computers and Mathematics Laborer C Construction and Extraction □ Cosmetology/Barber Legal D Data Processing - Education, Training, O Management Library Science | | | 0 Food/Lodging Services O Janitorial/Cleaning Service 0 D Landscape/Ground Maintenance O Other Life, Physical, and Social Science | Military Service O Office/Clerical/Administrative Support Production/Assembly Sales Tradesman (Electrician/Plumber/Mechanic) Transportation and Material Moving O Farming, Fishing, Forestry | | | | | | | | | PREVIOUS EMPLOYMENT/UNEMPLOYMENT | | | | | | | Start and End Dates Name of Employer/ Unemployed | | | Address of Employer | | Nature of Work, Hours Per Week, Salary, Reason for Leaving | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |

PS2 (Rev. 10/09)

| | | | | | FINANCIAL INFORMATION | | | | |-------------------------------------------------|-------------------------------|---------------------------------------------------|----------------|------------------------------------------------------------|-----------------------------------------------------------|------------------------------|--------------------|--| | | | ASSETS | | | LIABILITIES | BALANCE | MONTHLY PAYMENT | | | Cash | | સ્તિ | | nork. | Rent or Mortgage Payment | | | | | Savings Account | | સ્ત્રે | 500 | ,000 | Other Mortgage | | | | | Checking Accoupt or San San Fen | | ਦਿੱਤੇ | 400,000 | | Past Due/Pending Foreclosure? | | | | | Stocks/Bonds/Retirement Accounts? | | | O Yes No | | O No O Yes | | | | | Describe: | | ਦਿੱਤੇ | | | | | | | | | | | | | Utilities | | OLOTY | | | | | | | | Groceries | | | | | | | | | | Child Care | | | | | Other Accounts | | 6 | | | Child Support (Ordered or | | | | | | | ക | | | Voluntary?) | | | | | | | સ્ક્રન | | | Alimony | | | | | | | Valuable Property (collections, jewelry, etc.) \$ | | | Personal Loans | | | | | Business Assets | | S | | | Business Liabilities | | | | | Motor Vehicles - Ownership | | | | | Motor Vehicles - Loans/Leases | | | | | Year | Make | Model | | Amount | Creditor | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Real Estate: | 171 | milion e | | | Auto Insurance | | | | | Date Purchased: | | | | | Total Credit Card Debt | | | | | Address: | | | | | School Loans | | | | | Current Market Value | 8 | | | | Outstanding Medical Bills | | | | | Equity | S | | | | Outstanding Taxes/Fines/Restitution | | | | | Down Payment | ಕಾ | | | | Other Debts/Monthly Expenses | | | | | Have you ever filed for bankruptcy? | | O Yes O No | | | Type of Bankruptcy | | | | | Location of | | | | Year Filed: | | Amount Discharged: | | | | EMPLOYMENT INCOME: | | | | | Other Source of Income: (Client Personal Data/Employment) | | | | | | | | | | | | | | | Yearly/Monthly/Weekly \$ | | | Alimony | ಕ್ಕಿ Payback on Loans ਚਰੇ Retirement Pension S | | | | | | | | | Child Support | Disability Insurance/ S Severance Pay ਦਿੱਤੇ | | | | | | PAYMENT METHOD: (Circle One) Check Cash | Commission | Other | | Employee Benefit Trust ਉ | | | | | | | | | Dividend | | 8 | Unemployment Comp. | | | | SPOUSE/SIGNIFICANT OTHER'S | | | Family Support | | ਦਰ Unknown | | | | | OCCUPATION: | | | Food Stamps | | ਦੇ ਰੋ Other | | S | | | | | | Investments | | ನಿ Social Security (retirement) | | | | | Yearly/Monthly/Weekly Lawsuit Payout ક્ક્ | | | | | | Social Security (disability) | S | | | | Yearly/Monthly/Weekly ಕ್ಕೆ | | | | | | | | | NOTES: | As taxes | | | | 1,500 per month. | | | |

PS2 (Rev 10/09)

| (Rev. 10/09) | | | | | | |------------------------------------------------------------------------------------------------------------------------------------------------|-----------------|----------|-------------------------------------------------------------|----------------------|------------------------| | <div style="text-align: center;">HEALTH</div> | | | | | | | <div style="text-align: center;">Physical Health</div> | | | | | | | Brief Description: Healthy | | | Current Insurance Carrier: | | | | Physical Health Status: (Client Personal Data/Profile) | | | | | | | [ ] Minor Medical Problems Only | | | [ ] Diagnostic Evaluation or Specific Treatment in Progress | | | | [X] Significant Medical Disorder (Under control but follow-up care required) | | | [ ] None | | | | [ ] One or More Chronic or Recurrent Medical Problems | | | [ ] Unknown | | | | [ ] Uncontrolled Significant Disorder | | | | | | | Names of Medications and Reason(s) for Use: | | | | | | | <div style="text-align: center;">Mental Health</div> | | | | | | | Current Mental Health Status: (Check all that apply) | | | | | | | [X] No evidence of a current or past mental health condition (No evidence of current or past mental health condition) | | | | | | | [ ] History of a mental health condition. No active symptoms. (Documented history of mental health condition; no current active symptoms) | | | | | | | [ ] Mental health condition requiring ongoing treatment. (Reported active symptoms and requires treatment) | | | | | | | [ ] Has been in therapy within the last 12 months for a mental health condition. (Has sought or been in some form of treatment) | | | | | | | [ ] Currently taking medication for a mental health condition (psychotropic drug). (Taking meds for management of active symptoms) | | | | | | | [ ] Has seen a physician within the last 12 months for a mental health condition. (Sought treatment through a physician for active symptoms) | | | | | | | [ ] Has been hospitalized within the last 24 months for a mental health condition. (Has been hospitalized due to condition) | | | | | | | Have you ever seen a doctor for any emotional or psychiatric problems? [ ] Yes [X] No [ ] Unknown If yes, when, where, and last visit? | | | | | | | Have you ever been hospitalized for emotional problems? [ ] Yes [X] No [ ] Unknown If yes, when and where? | | | | | | | Have you ever thought of or attempted suicide? [ ] Yes [X] No [ ] Unknown If yes, when, and what method was used or thought of? | | | | | | | Do you have current thoughts of suicide, hearing voices, or seeing things? [ ] Yes [ ] No [ ] Unknown If yes, explain. | | | | | | | Have you ever been prescribed medication for emotional or psychiatric problems? [ ] Yes [ ] No [ ] Unknown | | | | | | | If yes, name of medication(s) and how long you used it: | | | | | | | Do you have a history of gambling? [ ] Yes [X] No [ ] Unknown | | | | | | | If yes, describe the type of gambling activities, frequency, and amount: | | | | | | | Do you have a history of domestic violence? [ ] Yes [X] No [ ] Unknown Explain: | | | | | | | <div style="text-align: center;">Mental Health Treatment</div> | | | | | | | Dates | Name of Program | Location | Purpose | Inpatient/Outpatient | Completed? If no, why? | | | | | | | [ ] Yes [ ] No | | | | | | | [ ] Yes [ ] No |

PS2 (Rev. 10/09)

| SUBSTANCE ABUSE HISTORY (Client Personal Data/Profile) | | | | | | | |--------------------------------------------------------|-----------------------------------------------|---------|------------|------------------|--------------|-----------------------| | Drug Use | Indicate Drugs of 1st, 2nd, and 3rd Choice | Current | History of | Age Use Began | Last Used | Frequency Used | | Alcohol | SOCIAL: Yes / No | ☐ | ☐ | | | Few wk. don't ago. | | Amphetamines | | ☑ | ☑ | 25-30. | Socially. | | | Benzodiazepines | | ☐ | ☐ | | | | | Cannabinoids | | ☐ | ☐ | | | | | Club/Designer Drugs | | ☐ | ☐ | | | | | Cocaine | | ☐ | ☐ | | | | | Hallucinogens (PCP, | | ☐ | ☐ | | | | | Heroin | | ☐ | ☐ | | | | | Methamphetamines | | ☐ | ☐ | | | | | Prescription Opiates | | ☐ | ☐ | | | | | Other | | ☐ | ☐ | | | |

## Substance Abuse Status:

O No substance abuse/dependence history (No evidence of current/historical substance abuse/dependence)

D Sustained remission (Counting today, defender has demonstrated > 12 months of abstinence following history of substance abuse or dependence) D Early remission (Counting today, defender has demonstrated >1 month of abstinence following history of substance abuse or dependence)

O Actively abusing substances (Defendant does not meet the criteria for dependences in the past month and meets one of the following: a) Substance use resulting in a failure to fulfilm at work, school or home; b) Substance use in situations where it is plysically hazardous; c) Substance use related legal problems; d) Continued substance use despite that it causes relationship conflicts )

D Actively dependent on substances (The defendant has abused substances in the following: a) Tolerance: a need for increased anounts of a substance to adiminished effect with continued use of the same anount of the substance; b) Withdrawn! Physical illness associated with not taking the substance to avoid this ilhess; c) The substance is aken in larger anounts and over a longer period than intended; d) There is a desire or unsuccessful effort to reduce or control usage; e) A great trying to obtain, use or recover from use; f) Social, recreational or occupational activities are given use; g) Substance use is continued despite the knowledge of having a problem

| | | | | Substance Abuse Treatment | | | | | | | |-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------|--|----------|---------------------------|--|--------------------------|----------------------------------------------------|--|--|--| | Substance Abuse Treatment History (Check all that apply) | | | Current | History of | | | Notes | | | | | Inpatient Treatment | | | 0 | | | | | | | | | Outpatient Treatment | | | D | D | | | | | | | | Self-Help (AA/NA) | | | 10 | D | | | | | | | | Confined Treatment Program (BOP) | | | 0 | 0 | | | | | | | | | | | | | | | | | | | | Dates | Name of Program | | Location | Purpose | | Inpatient/ Outpatient | Type of Discharge (Satisfactory/Unsatisfactory) | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | If a drug test were taken today, would'it reveal any illegal substance or medications? @ Unknown If so, what illegal drugs/medications? Would you like to receive treatment? [ Yes = [ No | | | | | | | | | | | | ADDITIONAL NOTES | | | | | | | | | | | | | | | | | | | | | | |

PS2 (Rev. 10/09)

(Rev. 10/09)

**Computer Information**

| Do you have a computer in your home? □ Yes □ No | Was the computer seized? □ Yes □ No | |-----------------------------------------------------------|--------------------------------------------------------------------------| | What type of computer do you have? | What operating system do you have on the computer? | | | | | Do you have a PDA, Palm, Cell Phone with internet access? | If used for employment, does employer monitor internet usage and have an | | □ Yes □ No If Yes, What? | internet policy statement? | | | | | Who is your internet service provider? | How do you access the internet? | | | | | What purpose do you use the computer? | Anyone else in the home use a computer and for what purpose? | | | | | What peripheral devices do you have? | Note: | | | |

**SELF-REPORTED CRIMINAL HISTORY (including juvenile adjudications)**

| Date Arrested/Age | Agency/Location | Offense Charged and Bail | Disposition or Next Court Date | |-------------------|-----------------|--------------------------|--------------------------------| | | | | | | | | | | | | | | |

| Probation/Parole History? □ Yes □ No | Where? | Any violations? | |---------------------------------------------------------|-------------|-----------------| | | | | | Probation/Parole Officer's Name, Address, and Telephone | | | | | | | | Are you a member of, or have you ever been in a gang? | □ Yes □ No | |

| Gang Name | Initiation Date | When did you get out? | |-----------|-----------------|-----------------------| | | | |

| Will this information bring harm to you or your family? | □ Yes □ No | |---------------------------------------------------------|-------------| |---------------------------------------------------------|-------------|

**INTAKE - Prior Tab**

| Prior Failures to Appear: | Prior Escapes: | Prior Abscondings: | |---------------------------|----------------|--------------------| | | | |

| Prior Record | Charges (No.) | Convictions (No.) | Drugs (No.) | Violent (No.) | Pending Cases (No.) | |--------------|---------------|-------------------|-------------|---------------|---------------------| | Misdemeanors | | | | | | | Felonies | | | | | |

**INVESTIGATION - General Tab (Complete when an investigation is completed)**

| Docket No.: (e.g., 1:07M101 or 1:07CR101) | Defendant No.: | Type of Investigation: | |-------------------------------------------|----------------|-----------------------------------------------------------------| | | | □ Pretrial Services □ Material Witness □ Pretrial Diversion |

| Investigation Officer: | Date Assigned: | Date Due: | Date Report Submitted: | |------------------------|----------------|-----------|------------------------| | | | | |

| Temporary Duty? □ Yes □ No | | |-------------------------------------------------------|-------------------------------------------------------------------------------------------| | Judicial Officer: (Leave blank if pretrial diversion) | Jurisdictional Authority: | | | □ Court (District Court) □ Other District □ Magistrate □ U.S. Attorney (Use for PTD) | | | |

PS2 (Rev. 10/09)

| INTAKE - Opening Tab | | | | |-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------| | Case Activation | Assigned Officer: | Juvenile? □ Yes □ No | Sealed? □ Yes □ No | | Was the instant offense committed while under the criminal justice system? □ Yes □ No | | | | | Was the case diverted post-charge? □ Yes □ No | | | | | Referral Type: | Type of Case: (Intake Type) | Charging Document: | | | <div>□ Arrest</div> <div>□ Summons</div> <div>□ Verbal Notice</div> <div>□ Writ-Release Not Possible</div> | <div>□ Diversion</div> <div>□ Material Witness</div> <div>□ Pretrial Services</div> | <div>□ Citation</div> <div>□ Complaint</div> <div><div>□ Indictment</div><div>□ Information</div><div>□ Not Applicable</div><div>□ Violation Petition</div></div> | | | Rule 5 Transfer In? □ Rule 20 Transfer In? □ Courtesy In? □ Yes | | | | | Transfer District: | Transfer District Docket No.: | Transfer District PACTS No.: | |

Arrest is used when: 1) the defendant appears in court following an arrest, with or without a warrant, 2) the defendant turns himself/herself in or self-surrenders on a warrant. Writ is used when the defendant appears in federal court but remains under the jurisdiction of another agency

with no eligibility for release within 90 days. If the defendant appears pursuant to a writ but is eligible for release within 90 days, use "arrest." Verbal Notice is used when the defendant's appearance in court is not a result of any of the above procedures-for example, if the defendant voluntarily appears in court pursuant to agreement and no formal summons, warrant, or writ has been issued.

| INTAKE - Interview/Report Tab | | | |---------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------| | Interview Status: □ Interviewed □ Refused Interview □ Unable to Interview □ Not Applicable | When was a bail report submitted? (N/A if Report Type = None) □ Pre-Initial Hearing □ Pre-Detention Hearing □ Post-Release | How was the bail report submitted? (N/A if Report Type = None) □ Oral □ Written | | Report Type: □ Full □ Modified (Illegal Re-Entry Only) □ Addendum (Rule 5) □ None | PSO Recommendations: (Final) □ Detention □ Release With Supervision □ Release Without Supervision | AUSA Recommendations: (Final) □ Detention □ Release With Supervision □ Release Without Supervision | | Defense Counsel's Name and Telephone No.: | | AUSA's Name and Telephone No.: | | ADDITIONAL NOTES | | | | | | |

## PS2

(Rev. 10/09)

# INTAKE - Offense Tab/Charged Offense

# Class of Offense:

□ Felony-Class A - life or death

Check ONE appropriate Charge Classification/Category/Subcategory for the charged offense:

- □ Misdemeanor-Class A 1 year or less but more than 6 months □ Misdemeanor-Class B - 6 months or less but more than 30 days - □ Misdemeanor-Class C 30 days or less but more than 5 days - □ Infraction 5 days or less, or no imprisonment is authorized - □ Felony-Class B 25 years or more - □ Felony-Class C Less than 25 years but 10 or more years - □ Felony-Class D Less than 10 years but 5 or more years - □ Felony-Class E Less than 5 years but more than 1 year

Citation: (In CM/ECF format)

| Charge Classification | Charge Category | Charge Subcategory | Charge Classification | Charge Category | Charge Subcategory | |--------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------|--------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------| | Drugs | Continuing Criminal Enterprise Distribution/Trafficking Drug Paraphernalia Import/Export Manufacture/Cultivation Possession Possession While in Prison Other Use of a Communication Facility | Heroin Other Opiate Methamphetamine Cocaine Marijuana MDMA Prescription Drugs Other Drugs Near School | Traffic / DWI | Driving Under the Influence Driving While License Susp/Revoked Drunken Driving General Traffic Leaving Scene of Accident Reckless Driving | | | Obstruction / Escape | Bribery Contempt of Court Detention of Material Witness Escape Evidence Tampering Failure to Appear General Obstruction Harboring Fugitive Juror Tampering Mail Obstruction Misprision of a Felony Obstruct Justice Offense Committed While on Release Perjury Resisting Arrest Witness Tampering | | Immigration / Customs | False Statements in Application of Passport False Statements Fraudulent Papers Illegal Entry Illegal Re-Entry Illegal Re-Entry After Deportation Impersonation of U.S. Citizen Misuse of Passport Other Immigration Smuggling Aliens Smuggling Goods into U.S. | | | Public Order | Accessory After the Fact Adulteration of Food or Drug Contraband in Prison Civil Disorder Contributing to Delinquency of Minor Criminal Mischief Damage to Property Destruction of Mail Disorderly Conduct Environmental Violations Game Conservation Act Interference with Flight Crew Lewd Conduct Misrepresentation of U.S. Employee National Parks Violation Open Container Violation Prostitution Public Intoxication Trespassing Other Public Order | | Weapons / Firearms | Armed Career Criminal Concealed Weapon Drug Crime of Violence During Drug Offense Export of Weapons/ Munitions Export / Import Felon in Possession Import Explosives Interstate Shipment Other Unlawful Possession Other Weapon Possession in Prison Sell to Unauthorized Persons Selling Defaced Firearms Supplied to Drug Traffickers Transportation of Stolen Weapons Use/Distribution of Explosives | |

| | O Animal Cruelty ಿ Arson | | | O Access Device D Concealment of Assets Copyright Infringement | | |--------------|----------------------------------------------------------------|-------------------------------------------------------------------------|-------------|------------------------------------------------------------------------------------------------------------------------|-----------------------------| | | Assault | Aggravated □ Attempted Murder General ロ Simple With Battery | | Counterfeiting | Currency G General | | | | O With Weapon | | Embezzlement | Bank Postal G General | | | □ Bank Robbery | O Armed O Unarmed | | Engaging in Monetary Transactions Export/Import Monetary | | | | Burglary | O Bank General O Postal O Residential | | Instrument ロ Failure to Pay Child Support False Claims O False Financial Statements ロ Food Stamp Violation | | | O Violence / | □ Child Exploitation | | O Financial | | | | Sex Offenses | D Child Molestation Child Trafficking | | Offenses | Forgery | O Checks O Instrum / | | | D Domestic Violence O Extortion, Threats | | | | Securities O General | | | O Failure to Register Sex Offender | | | □ Fraud | O Bank | | | D General Sex Offense | | | | O Bankruptcy | | | General Violence ロ Human Trafficking | | | | C Computer C Credit Card | | | O Kidnapping | | | | ್ General | | | | | | | O Healthcare Housing | | | | | | | Identity | | | O Manslaughter | General ロ Vehicular | | | O Passport O Securities | | | | O First | | | D Wire | | | O Murder | D Second | | O Gambling / Lottery | | | | | General | | Interstate Transactions O Misuse of Social Security No | | | | | | | D Money Laundering | | | | D Negligent Homicide O Poss. Of Child Pornography | | | D Receiving Stolen Property ロ Satellite Piracy | | | | D Racketeering | | | O Structuring Transactions to | | | | Rape | | | Avoid Rpt | Evasion | | | | 0 Armed | | O Tax | O Failure File | | | Robbery | General D Motor Vehicle | | | G General Liquor | | | | Unarmed | | | Trafficking | | | | | | | Contraband Cigarettes | | | O Sexual Abuse | | | | | | | D Sexual Abuse of Minor O Stalking | | | o Theft | O Auto | | | D Threatening Communications | | | | Bank | | | O Transportation for Prostitution □ Transportation of Minor | | | | Firearms Dealer | | | D Violation of Restraining Order | | | | General | | | | | | | Ident. Docs Identity | | | | | | | O Mail | | | | | | O Transportation Stin Property | | | | | | | O Worthless Checks | |

PS2 (Rev. 10/0

| | | | | RELEASE/DETENTION ORDERS | | | | | | |-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------|------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------|--------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------|--|--| | Hearing | Order Date | Release/Detention Outcome | | Type of Bond (if released) | Release Date | | Detained Due to/ Judge Issuing Order | | | | Initial | | O Released Detained | | C Collateral Bond D Percentage Bond O Personal Recognizance 0 Surety Bond O Unsecured Bond | | | Temporary Detention O Held for Detention Hearing Consent to Detention Preventive Detention D Flight O Danger O Both JUDGE: | | | | Detention (if held) | | O Released D Detained | | □ Collateral Bond D Percentage Bond O Personal Recognizance Surety Bond O Unsecured Bond | | | Preventive Detention O Flight O Danger O Both Consent to Detention JUDGE: | | | | | PSA SUPERVISION | | | | | | | | | | Date Released to Pretrial Supervising Officer: Supervision: | | | | Courtesy Pretrial Services Out? O Yes D No | | | District Providing Courtesy Pretrial Services or Courtesy Diversion Supervision: Supervision | | | | PTD Expiration Date: PTD Months: | | | | | | | | | | | | | | | COURT-ORDERED RELEASE CONDITIONS | | | | | | | Check all conditions that were ordered by the court: (See PACTS Conditions Module for definitions) TREATMENT/COUNSELING/ TRAINING-RELATED CONDITIONS D Substance Abuse Evaluation ---------- D Drug Treatment O Alcohol Treatment Only D Substance Abuse Testing D No Illegal Use of Controlled Substances O No Excessive Alcohol Use O No Tampering with Substance Abuse Test Alcohol Abstinence O Mental Health Treatment D Sex Offender Assessment D Sex Offender Treatment Life Skills Counseling Education/Training Requirements O Other Treatment/Training/Education O Mental Health Evaluation DNA Testing SEARCH/SEIZURE/COMPUTER O Search/Seizure Computer Search Computer/Internet Restrictions | | | SUPERVISION REPORTING/ CUSTODIAN CONDITIONS O Third-Party Custody: D Cosigned by: Cost O Pretrial Services Supervision D Report Change of Address P Personal Reporting Frequency Amount: D Daily O Weekly @ Monthly Q Quarterly O Yearly Telephone Reporting Frequency Amount: D Daily = Weekly = Monthly Q Quarterly □ Yearly D Report to Law Enforcement FINANCIAL/SERVICES RELATED CONDITIONS O Restitution \$ C Community Services Hours D Other Financial Obligations O Other Service Obligations OTHER O Other condition | | | LOCATION/EMPLOYMENT ASSOCIATION RESTRICTIONS Location Monitoring - Program specify one in each column for monitoring O Home Incarc D Voice Verification O Home Detention ORF C Curfew - - - - - O Passive GPS □ Active GPS GPS □ RF/GPS Combo O Not Specified Location Monitoring - Other O Stand Alone Monitoring Re-Entry Center - Full Time Re-Entry Center - Part Time D Work Release From Secure Facility D Residential Requirements/Restrictions Travel Restrictions Weapons Restrictions O No Possession of Pornographic Material O Obtain/Maintain Employment Surrender Passport O Obtain No New Passport O Employment Requirements/Restrictions No Contact With Victim/Witness D No Contact With Minors Association Restrictions 0 Report Contact With Law Enforcement O Other Location/Employment/ Association Restrictions | | | |

PS2 (Rev. 10/09)

| INTAKE-Closing | | | | |--------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------|---------------------------| | Closing Date: | Disposition: □ Acquitted □ Close-Courtesy Only □ Deferred Judgment □ Dismissed □ Diversion Denied □ Diversion Terminated by Gov't □ Execution of Sentence □ Found NGBRI □ Fugitive FTA □ Other □ PTD Satisfied □ Transferred Out | | | | Transfer District: | Docket No.: | Defendant No.: | Voluntary Surrender Date: | | ADDITIONAL NOTES | | | | | Notes: | | | | | | | | |