UNITED STATES FUGITIVE APPREHENSION & TRANSPORT
24 Hr Dispatch: 361-853-5000 Dispatch Fax: 361-853-1003
CONTRACT FOR EXTRADITION / TRANSPORT
Requesting Agency:
Billing Address:
Authorizing Officer / Title:
Name
First Name
Last Name
Signature:
Phone:
Fax:
E mail:
example@example.com
Prisoner - Full Name:
Name
LASTName
First Name
Middle Name
Last, First, Middle
Sex:
Height:
Weight:
Eye Color:
Hair Color:
Race:
D.O.B:
S.S.N.:
Assignment Type:
Writ
Extradition
Bench Writ
Chain
Medical
MHMR/MHD
Juvenile
Hospital Duty
Other
Known Charges:
Known Charges cont'd
Pick Up By-Date:
Date
-
Month
-
Day
Year
Date
Deliver by Date
Deliver On Date:
/
Month
/
Day
Year
Date
Known Threat Group
Affiliation:
Known Threat Group Affiliation:
Details/Information:
Special Transport Details/information:
Pick Up/Holding Facility:
Facility Address:
(Correct Address Required)
CITY:
State:
ZIP Code
ZIP:
Contact Person At Pick Up
Contact e-mail
24 Hr. Phone / Ext:
FAX#
Special Instructions or Medical Issues
Holding Facility ID #:
(Correct Address Required)
Receiving or Destination Facility
Destination Facility Address
City:
State
Zip:
Contact Person:
Contact Person:
E Mail:
example@example.com
24/Hr Phone / ext
Fax
Special Instructions or Medical Issues:
Receiving Facility I.D.
Preview PDF
Submit
Should be Empty: