PER 18 U.S.C. 3170 DEFENDANT INFORMATION RELATIVE TO A CRIMINAL ACTION - IN U.S. DISTRICT C OURT BY: INFORMATION INDICTMENT CASE NO. Matter Sealed: Juvenile Other than Juvenile USA vs. Pre-Indictment Plea Superseding Defendant Added Defendant: Indictment Charges/Counts Added Information Name of District Court, and/or Judge/Magistrate Location (City) Address: UNITED STATES DISTRICT COURT DISTRICT OF NEW MEXICO Divisional Office Name and Office of Person Furnishing Information on U.S. Atty Other U.S. Agency THIS FORM Interpreter Required Dialect: Phone No. Name of Asst. U.S. Attorney Birth Male (if assigned) Alien Date Female (if applicable) PROCEEDING Name of Complainant Agency, or Person (& Title, if any) Social Security Number person is awaiting trial in another Federal or State Court (give name of court) DEFENDANT Issue: Warrant Summons this person/proceeding transferred from another district per (circle one) FRCrP 20, 21 or 40. Show District Location Status: Arrest Date or Date Transferred to Federal Custody this is a reprosecution of charges Currently in Federal Custody previously dismissed which were dismissed on motion of: Currently in State Custody U.S. Atty Defense SHOW Writ Required this prosecution relates to a DOCKET NO. Currently on bond pending case involving this same defendant. (Notice of Related Fugitive Case must still be filed with the Clerk.) MAG. JUDGE prior proceedings or appearance(s) Defense Counsel (if any): CASE NO. before U.S. Magistrate Judge regarding this defendant were FPD CJA RETD recorded under Appointed on Target Letter Place of County offense This report amends AO 257 previously submitted OFFENSE CHARGED - U.S.C. CITATION - STATUTORY MAXIMUM PENALTIES - ADDITIONAL INFORMATION OR COM MENTS Total # of Counts Title & Section/Offense Level Set Description of Offense Charged Count(s) (Petty = 1 / Misdemeanor = 3 / Felony = 4)