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r-ORM2131 (5(88):

STATE OF NEW YORK

M

1"::\03

DEPARTMENT OF CORRECTIONS AND COMMUNITY SUPERVISION

INMATE GRIEVANCE COMPLAINT

CODE

\::,;J

DO NOT WRITE IN THIS AREAIlGRC USE ONLY

Denied Mail

SHORT TITLE

SOUTHPORT CORRECTIONAL FACILITY

~
CHECK IF CONSOLIDATED

GRIEVANCE

o
Date:'
~----Name

-

-

----

-

---------DIN-#:-~

Wednesday, June 27, 2012
HOUSing-Unit:~--

Program AM:

PM:

-------

(Please Print or Type ~ This form must ~e filed within 21 days of Grievance Inddeot;

**Brief Description of Problem:

NOTE; INDICATE PERSON/AREA CONTACTED TO RESOLVE COMPLAINT

Grievant states that he was denied his son's report~card in the mail. He was told "We don't send reports to your cell.". He
asserts that he has been receiving report cards.

1

I'.

l,

, Cell Loc~tion at tin~e of gl'içvallce:~

Grievant
,Signature.

**ENTlRE GRIEVANCE ATTACHED HERETO

------~----------------~
1/1
, 1/ ~--"-__
Grievance Clerk:

Advisor Requested:

OYES

D NO

.--""'-,,....
Date:

6/27/2012

Who:

Action requested by inmate:

Grievant requests to be able to receive his children's report cards In the mail.

This Grievance has been Informally resolved as follows:

This Informal Resolution is accepted:
(To be completed only if resolved prlor to hearing) .
Grievant
Signature:

Date:

If unresolved, 'you are entitled to a hearing by the Inmate Grievance Resolution Committee (IGRC).
*An exception to the time limit may be requested under Directive #4040, section 701.6 (g).

~-_

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