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       NOTIFICATION TO COME BY MAIL ROOM

            V% (}fl             ‘           UNIT

Inmate NameN    (                            Date   i ( (S
lnrnateNo.HOL4LQ I

The above namdJnmate is required to come to te mail room
                        f)
                          (Date and Time)

regarding the following matter:

        Questionable Correspondence
        Questionable Publication
        Package
  ‘1    Legal, Special, or Media Correspondence
        Other

Inmate’s Signature_______________________ Date

Notifying
Officer’s Signature   ‘i,   .   fl 121 (
Original—Return to unit mail room.
Copy—Give completed copy to inmate.                   I-152
