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




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