DOJ-OGR-00024713.pdf

Page 74 Form 583 Report of Incident Incident #: NYM-19-0076 Submitted By: Date/Time Of Incident: 7/23/2019 1:27 AM Injury Category: No Injury Sexual Assault: No Staff Injury by Inmate: No Section 4: Lethal Weapon Discharge No data found. Section 5: Use of Force No data found. Section 6: Description of Incident DESCRIPTION OF INCIDENT (If Use Of Force, include details such as name of supervisor applying the chemical agent and/or restraints, reasons for use of hard restraints instead of soft restraints, etc.) Please be clear about cause(s) of the incident in your description. [b)(7)(A) Section 7: Attachments File Date File Name Original Entered By Original Loc. Code No data found. Approved By: NOT COMPLETED UNCLASSIFIED/LIMITED OFFICIAL USE ONLY/LAW ENFORCEMENT SENSITIVE This document is marked Unclassified/Limited Official Use Only/Law Enforcement Sensitive and may be disseminated, with proper attribution, to active Law Enforcement, DOD, or U.S. Intelligence Agencies. This document, or any segment/attachment thereof, may not be released without the approval of the Bureau of Prisons to any media sources, any non-law enforcement entity, the general public or those without a "need to know." It contains information that may be exempt from public release under the provisions of the Privacy Act (5 U.S.C. 552). 3 of 3 DOJ-OGR-00024713