Anonymous 
[center:10mevgdh]City of Hatian Department of Corrections[/center:10mevgdh]
Probation Intake Questionnaire
Full Name: Rhage Krolmskull
Maiden or AKA name: Tichman2 Aeon
Address: Gein Burger
Phone number:555-567-8901
Charge(s)
HPC-103. Assault on a Police Officer
HPC-203. Assault with a Deadly Weapon
HPC-303. Resisting Arrest
HPC-304. Obstruction +12
Age 37
Birth date 6/21/1975
Birth Place Frankfurt, Germany
Race or Color Caucasian
Height 8" 2'
Weight: 398 lbs
Eyes Blue
Scars Marks or tattoos: covered in tattoos
Number of children living in your household:2
Employer: Gein Burger
Bi weekly income: $2,000+
Probation Length: 6 months (1 rl week = 1 sl month))
Rules:
1. Rhage Krolmskull is not allowed at any time to posses any form of deadly weapon. Improvised or not this includes shivs.
2. Rhage Krolmskull with meet with his Probation Officer Jesus Montana monthly. Failure to do this could lead up to incarceration in the Hatian Jail for remainder of said Probation. ((usually 12 hour max depending on the charge))
3. Rhage Krolmskull is not allowed to posses or consume and alcoholic beverages or controlled substances at any time while on probation.
4.Rhage Krolmskull 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 Hatian Jail until Probation Officer releases said hold.
5. Rhage Krolmskull shall remain gainfully employed during said probation. Failure to obtain and or maintain gainful employment will result in incarceration in a Hatian jail.
6. Rhage Krolmskull shall attend and participate in Anger Management Classes.
Probation Agent Signature
Jesus Montana
Probation Client Signature:
Rhage Krolmskull(Tichman2 Aeon)