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 Name:    -~clJl;____L(hn, W          l\   SQ   .                     No:   _ll.O:Zll (6       Unit:   \3 (
 Living Quarters:        l~ C::,   -1) -   Z.l{o.~- ....-             Work   Assignment:_A~                   . _ __ __

 DISPOSITION: (Inmate will not write in this space)
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 fci-60(Rev.11-90)                                   0~
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                                                                        ~
                                                                                 ....
                            TEXAS DEPARTMENT OF CRIMINAL JUSTICE -INSTITUTIONAL DIVISION

                                               INMATE REQUESTTO OFFICIAL
REASON FOR REQUEST: (Please ctieck one)

PLEASE ABIDE BY THE FOLLOWING CHANNELS OF COMMUNICATION. THIS WILL SAVE TIME, GET YOUR REQUEST TO THE
PROPER PERSON,.AND GET AN ANSWERTOYOU MORE QUICKLY.

1.   0   Unit Assignment, Transfer (Chairman o.f.1C1a~sification,           5.   0      Visiting List (Asst. Director of classification, Administration
         Administration Building)                                                       Building)

2.   0   Restoration of Lost ov,                                            6.   0                        nts and related information (Unit Parole
         will be forwarded to the

3.   0   Request for Promotion in                                           7.   0
         (Unit Warden- if approved, wi!YDe
         of Classification)

4.   0   Clemency-Pardon, parole, early out-mandatory supervision           8.   0      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)                r\\
                                               Alf-. .              .
m        C.,t...t~f=J J4~ \- ~-,l a.oo,u\       j
                                    (Name and title of official)
                                                                                            DATE         ~ b- f~
                                                                                                              •


ADDRESS:                (_
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