RECEIVED IN

Tha Court of Appeals

Sixth District

APR 0 2 2015

Texarkana, Texas \

Debra Autrey, Clerk

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FILED IN

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APR 0 2 2015

Texarkana, Texas

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SUBJECT: State briefly the problem on which you desire assistance.

V>-

J"I <.pA3- 71 Utters 4e> <4Jip

Name: _

Living Quarters:

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rs: f-*~ ~5 Jj& Work Assignment: /u&K.x }Qtfl&r OS

DISPOSITION: (Inmate will not write in this space)

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£M>0(Rev.11-90) \A^ ^ ^~N -^
TEXAS DEPARTMENT OF CRIMINAL JUSTICE — INSTITUTIONAL DIVISION

INMATE REQUEST TO OFFICIAL

REASON FOR REQUEST: (Please check one)

PLEASE ABIDE BY THE FOLLOWING CHANNELS OF COMMUNICATION. THIS WILL SAVE TIME, GET YOUR REQUEST TO THE

PROPER PERSON, AND GET AN ANSWERTO YOU MORE QUICKLY.

TO:

1. M Unit Assignment, Transfer (Chairman of Classification,

^Administration Building)

2. G Restoration ofLost overtime (Unj/Warden-if approved, it

will betorwarded to the Statarffsciplinary Committee)

3. G Request foSA^romotfon in Class or to Trusty Class

(Unit Warden-itefproved, will be forwarded to the Director

of Classification)

4. G Clemency-Pardon, paroi&earlyout-mandatorysupervision

lard of Pardons and Paries, 8610 Shoal Creek Blvd.

fAustin, Texas 78757)

Manroo^i

5. Sw Visiting List (Asst. Director ofclassification, Administration

"BvMr

6. G Parole requirements and related information (Unit Parole

Counselor)

7. G Inmate Prison Reoo'rd (request for copy of record, infor

mation on parpie eligibility, discharge date, detainers-Unit

Administration)

8. G Personal Interview with a representative of an outside

fncy (Treatment Division, Administration Building)

./S^y^'/s DATE:

ADDRESS:

{Name ana mieoi owaaij *a . ^
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