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UNCLASSIFIED//IAW ENFORCEMENT SENSITIVE (WhEN COMPIEIEd) <br />U.S. Department of Justice <br />United States Marshats Service <br />Date of Detention Review Name of Detention <br />FACILITY FACTS <br />FACILITY OVERVIEW <br />Name <br />Address <br />Phone Number <br />Fax Number <br />State <br />District <br />Number <br />Closest USMS Office Name <br />from Closest Driving Distance from Date of Last USMSClosest USMS Office Detention Review <br />minutes miles <br />"Other Notes Section" on last to document more than one of <br />of <br />Detention Facility Review <br />DFR <br />Code <br />Date <br />Driving Time <br />USMS Office <br />Points of Contact <br />needed, use <br />NorlcE: This document't'11",11^1i9R oFFtctAL us:.glll <br />"."0 <br />mav conrain LAWENFoR.EMENT sENsr,Try_E.9r coNFrDENTrAL.nrormarion <br />wtrich is for the sole use of il <br />:TPj:1tr*';;;"il'i;i"liHHflfj:ffi:l';g'mfj#ji",l..i"lt*:l*tl,;lls;,'J:;:f.:l";lllia*o,l1lff::;::,11:11H,,1.onlv to aid in providins heallhcare t.,iLt ro'r&lr"iiliron"r.. Rny orrer uselJ, ,Lr"rion <br />"r <br />eli"iJiriiFna Llw anolor me privacy Acr anrt wiil be <br />reported as such. <br />UNCLASSIFIED//LAW ENFORCEMENT SENSTTIVE (WhEN COMPIEIEd) <br />Form USM-2tg <br />Rev.OZl21 <br />Page 1 ot22