Case Information

*2 . '··: RBTURNTO:· .. TDCJ# · HOUSING __ _

: -. _Offen~er trust fund active/res4icted. Purchase supplie8:from comnussary

_Allowed (5) personallet~rs/$2.45 ·Per month and (5) legal items 'per week .

_J?id not demonstrate need for additional supplies/postage . .

_._Pen/carbon ~.change ~qwredftiid not demonstra~ need fo~· ((arbon . . .

~Djd not subniit requesytncomplete request . . · · · . · . . ,.., .

· · ·· J(_Maillet~r(s), _:_perso~, ~legal to receive more supplies, L~t~$11Ulce date: bSOJ?tJ · :

· . Pink ·slip required for offenders with active acct/no IP card · ·.

· 'Personal supplies issue.d once per montllllegal suppiies issued. once per week . _. _Use indigent supply ettveiope for requesting supplies/postage · · . . . __ Provide proof of purc~e for envelopes/paper not ~ssued thru indig~nt- supply·. ·

i ~~on :tiicligent offeride~~n1ay' receive siippi~es·aJfeY 1. cons·ecative dJj~ fockdow~ · . Contraband-riot allow.&! for mailing thru· indigent program . . .

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' 3. Tl-IE ACCUSED REASONS AND/OR DEfENSES HAVE BEEN LOGICALLY AND

} ' SYSTEMATICALLY INVESTIGATED AS FOLLOWS: A, cL\.-)\- I\ , REVIEWED' CASE .. · ---------------.:...---. ______ __, Ii . . ~.\!:_U, INTERVIEWED ACCUSE})~

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6. LIST THE PORTIONS OF THE INVES1"IGATION TH.;y::-APPE:AR TO SUPPORT HIE ACCUSED REASONS, AND/OR DEFENSES : - - - - - - - - - - - - - - · - - - - - ' - - - ·-----------·-- ····---~ =~~=---==-~.eec~---,--- _·--=._-_- _-_--------------~·-=__- __ --_-__ -_ ...... ----------·- ·-----·-- -------·---· TITLE: J:'hS.._- :l.-_ COUNSEL SUBSTITUTE PRINTED NAME:~~ 'i\An'\ COUNSEL SUBSTITUTE SIGNAT~REt __ D::t-h~~ _____ nATE :·:_.Q_=--(..t--=:.1~ CS-10.11B, REVISED 08/2005

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• • • Department of Criminal Juatl

INSnTUTIONAL DIVISION ,.;. ·~~

Inter - Office Communications Date: . .Q J ' I \ \ '.

To: _D_IS_C_IP_U_N_A_AY_H_EA_A ...... IN_G_O_F_FI_C_EA __

From: ~ flAr.c:..c:Jitk~S SubJect:· WITNESS STATEMENT

TIME: Dcts9 CASE# ~Q I 0 1.5:1Q.:>3 RANK: SHIFT/CARD ASSGN:.--=--

OFF ICER : ' - - - - - - - - - - - - TDCJ# ")q_c:;;:gHOUSING ASSIGN: y a?, INMATE:IOFFENDER: ~,..~tt>? a STATEMENT OF FA~TS BY WITNESS:

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""" Jt ^[0] •• .cs:()SP040 ~ T.D.C.J. 2011/02/1< ro·- ·roo7 S~ICE INVESTIGATION WORK SHIIW 12: 03:1~ CASE:t: 20110157273, TDCJ. t 01442303, NAME: SALIIZAR,ROLAND , RCVD: 020~~(;SRV~P=~ DATE: 0307ti c: --SE;iyic~l DATE:""~~~ ~ti:~ '" CURRENT UNIT: TO, OFFENSE DATE OTHER BLDEf 43 Af-1, LOCATION: TO UOT 12 06 : 020511, TIME: ^[1] CHARGING bFFICER: CHURCHMAN, I ^[5] 03 . OFFENSE CODES: A) COV B. DESCRIPTORS: A> SA SP I-lOUSING: 12FB1 B> I B) ^[15] CLASS1 L3, , I C) C) ^[1] H, CUSTO"OY: 3A, TYPE:' I D) SHIFT/CARD: 1/2, D> ,

CS ASS! GNED: --·-----·--------------~ ~ _ SE RVI CF. 1' UtE: COUNSEL SUBSTITUTE HAS BEEN APPOINTED BECAUSE:

~ACCUSED IN ANY fORM OF E. ACCUSED HilS REQUESTED COUNSEL EA BELOW 5.0 B. SEGREGATION IQ BELOW ^[73] F·. ACCUSED HAS REQUESTED WITNESS WHQ SUBSTITUTE

C. LITERACY IS QUESTIONABLE 0 CAN NOT ATTEND THE HEARING .· D. ACCUSED HAS DIFFICULT~·UNDER­ COMPLEXITY OF CASE WARRANTS COUNSEL

STANDING ENGLISH SUBS·TITUTE .•==-=-=====·=====-======•:::.;::.;:::::::::::::::::::::=::.:::.::.::::==========:.:=====:..::::===::.::.:===:=:.::::r..:::::::u::::::::.::=~=:::.:::. *10 A. OFFICER'S REPORT CLEARLY DESCRIBES THE INCIDENT IN QUESTION: YES_NO __

B. CHARGES LIST,ED WERE REVIEWED WITH REFERENCE TO TDCJ DISCIPLINARY ..._,/ RULES AND PROCEDURES: YES __ NO. __ C, OFFENSE DESCRIPTION IN REPORT SUBSTANTIATES EACI-1 OF 'TI-lE ~; ALLEGED OFFENSES WERE VIfJLATtD: YES ___ NO ____ _ -------------·--- ··---------------------------- IF NO I EXPLAIN:·------'- 1, THE ACCUSED WAS tNFORf1ED OF THE FOLLOIJING RIGHTS: YES NO

A. TO GALL AND QUESTION WITNESSES ~--- B. TO PRESENT DOCUMENTARY EVIDENCE ~--·-, C. TO BE REPRESENTED B't COUNSEL SUBSl"I·TlJTE ·' ;::;:;::-----'- D. TO CALL AND QUESTION THE CHARGING OFFICER AT THE HEARING ~-- E:, THE ACCUSED STATES HE/SHE UNDERSTANDS REPORT, CHARGES AND RIGHTS. --:------· F, THE ACCUSED STATES HE/SHE WISHES T~ ATTEND H1S/HER HEARING ---· =~===::.:=====~==:.:====~===========~========,.,==~==::.:=~==::.:~==:.:============~=========~ 2, THE .ACCUSED REASONS AND/OR DEFENSE 1 - - - - - - - - - - - - - . , - - - - - - - · - - - :~ ~~· \ D c;L0; - - - - - - ·--------- ~o ... Q::t;.,,o ~ c~ ....... ~et"l"' . :-------·-- d \)

----------·-·------·--------·- ·--------"-- --:--· ·----·-------

:s:-REQi:iEsTED DiJCUHENTARY EVIDENCE·-----=-~--------~~==~ ----------------------·--------~-----------------------------------~ ·----- ·-------------------- ·-------·-----------------· --------------- CS-10.11A REVISED 10/02

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