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International Extradition
Request for Provisional Arrest
- Name of fugitive:
- Case caption (if the fugitive is not the principal defendant in the
case):
- Date discussed with OIA and name of OIA contact:
- Prosecutor responsible for this request (name, telephone number, fax
number,
E-mail address):
- Case agent (name, agency, telephone number, pager number and fax
number):
- Name, telephone number, and fax number of State extradition official
who
authorized payment of all expenses required to complete extradition (State
requests only):
- List all charges for which extradition will be sought (name and
statutory
citation):
- Warrant information (name of court (district and division), docket
number,
name of judge or magistrate who signed the warrant, date of warrant):
- Description of fugitive:
- aliases:
- date of birth:
- place of birth:
- citizen of:
- passport number/date and place of issue:
- other identity documents:
- height:
- weight:
- hair:
- eyes:
- other identifying features:
- Location of fugitive (full address and/or telephone number; names and
addresses of associates, etc.) and any contact in the foreign country aware
of
fugitives's location (Name, title, telephone and pager number.):
- Facts of case. [Using a narrative style, provide sufficient
information,
including date and place of offense, to establish probable cause that a
crime was
committed and that the fugitive committed it. Choose simple, descriptive
language that you might use in an affidavit in support of a warrant
application,
not the formal or statutory language of a formal charging document.
Continue on
a separate sheet if necessary.]
- Prosecutor's certification. [A statement by the prosecutor
acknowledging
that if the fugitive is arrested it will be necessary for extradition
documents
to be prepared according to the terms of the relevant treaty. Further, the
prosecutor must also certify that those documents will be prepared and sent
to
OIA according to the schedule set by the OIA attorney.]
[cited in USAM 9-15.230] |