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UNCLASSIFIED//LAW ENFORCEMENT SENS|TIVE (When Completed) <br />U.S. Department of Justice <br />United States Marshals Service Detention Facility Review <br />Date of Detention F Review D <br />FACILITY FACTS <br />Name of Detention Condu DFR <br />FACILITY OVERVIEW <br />Facil Name <br />Address <br />Phone Number <br />Number <br />Closest USMS Office Name <br />Fax Number <br />District <br />ent rivate <br />State Code <br />Date <br />Driving Time from Closest Driving Distance from <br />USMS Office Closest USMS Office <br />minutes miles <br />Points of Contact <br />{lf needed, use "Other Notes Section" on last <br />Date of Last USMS <br />Detention Faci Review <br />page to document more than one point of contact.) <br />Title Name <br />of Contact Phone Extension Email <br />NOTICE: This documenl is lntended FoR oFFlclAL usE oNLY and may contain LAW ENFORCEMENT SENS|TIVE oR ooNF|DENTIAL information <br />which is for the sole use of the intended recipient(s). Any unauthorized review, use, disclosure, or diskibution is prohibited. lf you are not the intended <br />recipient. please contact the sender and destroy all copies of lhis document. Any Protected Health lnformation contained in this document is to be usecl <br />only to aid in providing healthcare services to federal prisoners. Any olher use is a violation of Federal HIPAA Law and/or the privacy Act and will bereporled as such. <br />UNCLASSIFIED//LAW ENFORCEMENT SENSITIVE (When Completed) <br />Form USM.21B <br />Rev.07/21Page 1 of 22