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SUBJECT: -State briefly the problem on which you desire assistance. .         M>q 0®"/
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*>7* s^es^A^yKArtT* • ~i/o/4A                                            .

Name;_^<P^^^//>/>^^>V'^^                                                No: 767S73/7 Unit: ^^/^C^AA
Living Quarters:        _7f ^ ~~7S                                      Work Assignment: TffcrAAna/Ayj&Ss/yA/fC&AZf 0)
DISPOSITION: (Inmate will not write in this space)

                       y
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•£1-60 (Rev. 11-90)
                            TEXAS DEPARTMENT OF CRIMINAL JUSTICE— INSTITUTIONAL DIVISION ••                                - ,. •

                                           INMATE REQUESTTO OFFICIAL
REASON FOR REQUEST: (Please checkone) ._•-._                                                                                 v-
PLEASE ABIDE BY THE FOLLOWING CHANNELS OF COMMUNICATION: THIS WILLSAVE TIME, GET YOUR REQUEST TO THE
PROPER PERSON, AND GET AN ANSWER TOYOU MORE QUICKLY.

1. -•   Unit Assignment, Transfer.(Chairman of Class0ation,            5. d^Vjsiting List (Asst. Director otclassificationjAdministration
        .Administration Building).                                              Buila^q)
2. -•   RestoratibiigfLost overtime (Unityifarden-if approved, it.     6. •     Parole, requirements' and rei^fm information (Unit Parole
         will be forwardetH<ithe Stateptscipiinary Committee).                  Counselor)

3. •    Request for Promotion irf^CMss or to-Trusty- Class             7. •     Inmate Prison/tecorcHBequest for copy of record, infor-'
        (UnitWarden- ifjgpproved,.will be^warded to the Director               mation op^parofeeligibijity^dischargeidate, detainers-Unit
        of Classification)                                                     AdmiTstration)

A.- Q Clemency-Pardon, parole, earlyout-mandatorysupervision           8. •     Personal Interview with a representative of an outside
        (Board of Pardons and Paroles, 8610 Shoal Creek Blvd.                  agency (Treatment Division, Administration Building)
        Austin, Texas 78757)




TO:                   7^7 AT^AP 72777                                               DATE:        3       - JlS-/<?
                                (Name and title ofnfficial)

ADDRESS:                                                             SE^y-e//y 77%?A
