EFTA Document EFTA01301662

- 1 -Th U.S. Department of Justice United States Marshals Service UNCLASSIFIED//FOR OFFICIAL USE ONLY / FORM USM-78 I ARREST SHEET BIOGRAPHICAL INFORMATION Last name First name Maxwell Ghislaine DOB 14 4, DD ',WY' Subject address 12/25/1961 338 East Washington Rd. Bradford, New Hampshire Language English France Country of birth State Mother's country of birth France Race Weight :lbs Sex White 142 Female UCN ICEO rii,nitom I USMS Number FID Hair color Eye color BLK BRO Alien number A000000000 Middle initial Suffix N Father's country of birth Czechia Height :Ceti Height :liithe,1 5 7 SSN CASE INFORMATION Court case number Warrant number OFFICE 20 CR Arresting agent last name 330 MISC v Sealed case  High profile case Arresting agent first name Arrest location 338 East Washington Rd. Bradford, New Hampshire Arresting agent email address (must use a .gpv adds-sl Arresting agent phone Arresting agency ORI FBI SUBJECT INFORMATIOE Medical condition Coughing Coughing up blood Night sweats Unexplained fever Unexplained weight loss Mental condition Thoughts of suicide Thoughts of hurting yourself Thoughts of hurting others Known someone who has committed suicide Experienced and recent loss of a family member or close friend Wasfclid the subject Drug usage in the past 24 Hrs. Assaultive on arrest? In possession of a weapon? Gang affiliations Have martial arts training? r Yes rz No °Suspected Attempted to escape after arrest? Separatees CONFIDENTIALITY NOTICE: This report contains unclassified information of a sensitive, proprietary, health data or personally identifiable information (Pie which must be protected against release to unauthorized individuals and is the property of the U.S. Marshals Service. All emails, including all attachments, containing PII must be encrypted. Neither it nor its content may be disseminated outside the agency or personnel to which loaned without prior U.S. Marshals Service Authority. It is to be maintained, distributed, secured and disposed of in a manner that will protect the information against unauthorized disclosure and in accordance with The Privacy Act of 1974,5 USC § 552a. PAGE I MCC, UNCLASSIFIED//FOR OFFICIAL USE ONLY / SDNY_GM_001661112 irn= FORM USM-T8 EFTA_00 189787 EFTA01301662 U.S. Department of Justice United States Marshals Service UNCLASSIFIEW/FOU 0 / FORM USM-78 I ARREST SHEET ARREST INFORMATION Arrest date int/so/mil Was the subject housed in a jail or medical facility? Subject had property on arrest 07/02/2020 OJail °Medical @No If answered jail or medical facility, fill the designated fields below: Facility name Admit Date Release Date NCIC Offense Code Enticement of Minor for Prostitution - 6409 NCIC Offense Code Enticement of Minor for Prostitution - 6409 NCIC Offense Code Transport Interstate for Sexual Activity - 3622 NCIC Offense Code Transport Interstate for Sexual Activity - 3622 OYes 0 No 0 No, property retained by arresting agent Facility address Remarks Conspiracy Remarks Remarks Transportation of minors Remarks Conspiracy to transport NCIC Offense Code Remarks Perjury - 5003 NCIC Offense Code NCIC Offense Code NCIC Offense Code NCIC Offense Code IMPORTANT: Prisoner IS NOT in USMS cus:odv ll1ILL rernal2C'd by the Magistrate Judge. THE U.S. MARSHAL SERVICE DOES NOT ACCEPT ANY PERSONAL PROPERTY. DISTFOCT Calla NH CONCORD Remarks Remarks Remarks Remarks SUBMIT FORM CLEAR FORM NG( 2 W1021 UNCLASSIFIED//FOUO SDNY_GM_001661Rowycz= FORM USM-78 EFTA_00189788 EFTA01301663