Pi Sheriff's Offic Court Services Bureau WAIVER OF TWENTY FOUR (24) HOUR NOTIC) ne ‘Shave been advised that | have the right to @ written copy of the charge’s against me atleast twenty four (24) hours prior to appearing at the Disciplinary Hearing. | wish to waive this right and proceed with the Disciplinary Hearing at this time, Ge Date/Time aaa YTS Deputy's Signature’ re WAIVER OF APPEARANCE Check One: 01 MinorInfraction (1 Major infraction tnmate Signature Witnessed By: \ . have been advised of my right to appear at the Disciplinary Hearing on this date: Tdo not wish to appear, and hereby waive that right. x Tamate’s Signatore Date Deputy's Signature ‘Second Staff Witness REFUSAL OF APPEARANCE (at time of Hearing) Inmate Refused to Appear: Deputy's Signature ‘Second Staff Witness NOTICE OF DISCIPLINARY HEARING Faciity fs Le Date: I-16 7 Toinmate_ Mate a) WADE Number. YSGHEZ Aioges Vototon: YZ. At iecarwnl ve Qua Pholeeiy Date of offense: _ sb 2 DielDecrtonotnert —faalae wader arta Adcduese Qcely Cale lates rit ane afo Te TD SAD Heat ditt 48 LEGA Ad Abe ‘You are being referred to the Disciplinary Hearing for the above charge. The Hearing will be held within seven working days (excluding weekends and holidays), You are entitied to have a ful-time staff person assist you-at the Hearing. Please indicate below whether you desire to have a Staff Representative, and if so, his /hername. 0 1DO 11 DO NOT wish to have a Staff Representative. If so, the Staff Representative's nameis. - You will also have the fightto call witnesses at the hearing and to present documentary evidenco in your behalf provided, cling your witnesses will not jeopardize faclity safely. Names of witnesses you wish to call should be listed below. Bagh / ; LLL ZS, Min i tii The Heating Officer / Chairman. of the Disciplinary Committee will call those witnesses (Staff or Inmate) who are reasonably available, and who are determined to be necessary for an explanation of the written statements, INMATE RIGHTS Thereby acknowledge that | have been advised of my rights (as described on the back ofthis form) afforded me, and have received a copy of my charge. = a LN . a ’ Inmate's Signature Naive Prnies "Typed Cail ed Mo Scr oie VOR ee Seat Witwss (ern) ‘si Second Sat Winess (refused prin} 908 40029 (Rev 373 Vite: Reco Yalow Inmate i