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NEW COMMITMENT

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					                             NEW COMMITMENT
                       PROPERTY AND MONEY INVENTORY

DOC#:                      DATE:                      JAIL OR INSTITUTION
NAME:
ADA:                                                           SSN:

PROPERTY AND VALUABLES:

                        CHECK AMOUNT:                                 CHECK #:

        2 pr. Tennis Shoes (white or black only)
        5 pr. Tube socks (white only)
        5 pr. Underwear (white only; 5 bras for women (white only-no underwires)
        long underwear is permitted (white or gray/neutral only)
        5 t-shirts (white only)
        5 pr. Denim jeans (properly fitting; no "sagging" is permitted)
        5 chambray "work" shirts (blue only)
        1 belt (buckle must have blunt edges and cannot exceed 2"x2" nor 1 ½ oz. in weight)
        1 pr. suspenders
        2 blue sweat shirts and sweat pants (no hoods)
        1 Levi-type jean or denim jacket (buttons or snaps only)
        1 robe; 1 pr. pajamas
        1 pr. slippers; 1 pr. sandals; 1 pr. shower thongs
        1 hat (blue only) "Navy watch cap" style or baseball cap style (no logos)
        1 wrist watch; 1 band-type ring (no stones)
        1 pr. earrings (post only); 1 religious necklace
        prescription or reading eyeglasses; prescription contact lenses
        1 pr. non-reflective sunglasses
        medical-required prostheses
        1 cigarette lighter (clear see-through only)
        writing materials (clear pens, pencils, pre-stamped envelopes, paper)
        individual photos (not in frames or albums)
        address book (no other books or magazines are permitted)
        legal documents and paperwork

                                              NOTES




INMATE:
                                 signature

RELEASING OFFICER:                                         /
                                 print name                           signature

RECEIVING OFFICER:                                         /
                                 print name                           signature

INTAKE OFFICER:                                            /
                                 print name                           signature

                                                                                   DOC - 1757 (11/01)