City of Hathian Department of Corrections

 

Intake Form

 

Full Name: Sam-Warrhol-Kelly

 

Maiden or AKA name: n/a

 

Address: (swamp outside of town)

 

Phone number: 504-237-8300

 

Charge(s): HPC-103, assault upon a police office

48UPC-203, assault with a deadly weapon

48HPC-205, gang assault +72

 

Age 24

 

Birth date: 05/02/98

 

Birthplace Worcester, Mass

 

Race or Color white

 

Height: 6'4"

 

Weight: 189

 

Eyes: green

 

Scars Marks or tattoos: burn scars on right hand and wrist, missing fingernail on index and middle finger, scars on back and across belly, throat, multiple scars and gunshot wounds

 

Number of children living in your household: n/a

 

Employer: 24-Hour Pawn Shop

 

Income

 

Probation Length:

1 month

 

Terms of Probation:

1. Sam Warrhol-Kelly is not allowed at any time to possess any form of deadly weapon, improvised or not this includes shivs, while on probation.

 

2. Sam Warrhol-Kelly will remain GAINFULLY employed in a LEGAL job, failure to obtain or maintain legal employment could lead to incarceration, in Hathian Jail for the remainder of said probation.

 

3 Sam Warrhol-Kellywill meet with his Probation Officer Aley Jackson monthly.  Failure to do this could lead up to incarceration in the Hathian Jail for remainder of said Probation.  ((usually 12-hour max depending on the charge))

 

4. Sam Warrhol-Kelly is not allowed to possess or consume and alcoholic beverages or illegal or controlled substances at any time while on probation.

 

5. Sam Warrhol-Kelly will avoid police contact while on probation.  Any police contact will be reported to Probation Officer with in 24 hours, failure to report contact could lead to incarceration, in Hathian Jail until Probation Officer releases said hold.

 

 

Probation Officer Assigned: Aley Jackson