Arrest Process Intake Form
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2NYC Department of Finance
Office of the Sheriff
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ARREST PROCESS INTAKE
Mail to: County Office of the Sheriff where the services are to be made. County Sheriff locations are listed on the reverse side.
Instructions: Please read the entire page before completing this form and see reverse side for information regarding serv-
ice fees and borough locations of the Office of the Sheriff.
SECTION I - FIlINg parTy INFOrMaTION
Filing
Telephone
Party _______________________________________________________ Number: __________________________
PRINT FIRST NAME
PRINT LAST NAME
Address: ___________________________________ City: ____________________ State:______ ZipCode:_________
.
.
NUMBER AND STREET
APT
NO
SECTION II - COurT INFOrMaTION
The Warrant of arrest was obtained in the following Court:
q
q
q
q
FAMILY COURT
SUPREME COURT
CIVIL COURT
OTHER COURT
Court Address
and County: ___________________________________ City: _________________ State: _____ ZipCode: _________
NUMBER AND STREET
COUNTY
SECTION III - SubjECT INFOrMaTION
Person To Be
Social
Taken into Custody ______________________________________________ Security No: _______________________
PRINT FIRST NAME
PRINT LAST NAME
Address: _______________________________________________ Borough: _______________ ZipCode: _________
.
.
Alternate
NUMBER AND STREET
APT
NO
Address: _______________________________________________ Borough: _______________ ZipCode: _________
.
.
NUMBER AND STREET
APT
NO
Home Telephone No: ____________________________________ Cell No. ________________________________
Identifying
Date
Features/Tatoos: ________________________________________________ of Birth:________-________-________
MM
DD
YYYY
Vehicle(s): __________________________ Description______________________________ Picture Provided? _____
Habits, Movements, Hangouts, Known Associates:_______________________________________________________
_______________________________________________________________________________________________
q
q
Does your arrest involve the Sheriff taking custody of a minor?
YES
NO
If yes, please describe child or children, their age and explain any special circumstances:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
SECTION IV - gENEral INFOrMaTION
Indicate below any information which may be helpful in effecting a prompt and safe apprehension of the person: i.e. best time to serve warrant,
criminal activity at location, threats of violence, weapons, animals, person is emotionally disturbed or any other behavior or circumstance.
_______________________________________________________________________________________________
_______________________________________________________________________________________________
SECTION V - CErTIFICaTION
The undersigned hereby affirms to the best of his/her knowledge that the arrest mandate being filed is in full effect, and request is
made to the Sheriff for its enforcement by statutory authority.
_____________________________________________________________
__________________________________________
Signature:
Date:
Visit Finance at nyc.gov/finance
SH-0610
Rev. 1.27.2016
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