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Page 1: JiikTEX45ll3;?d - courtlistener.com · iM(LllM«SF£ TEtf, A, App, 33,1 3«t Atod Medi4 \l 3PArESKE5,Ldi?d 133. Ayd iP Wl (LdySTiruriEitUAlliPq dFTME STmTliR LdA-3 RJdF /(Ai5L id

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FILED IN COURT CF APPiAi-S12th Court of Appcai3 District

TECATHY S. LUSK

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UuMjTS\JiikTEX45ll3;?d

CO

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L IN THE UNITED STATES DISTRICT COURTVJ> FOR THE PMST^MJJ DISTRICT OF TEXASN f ~ DIVISION

Plaintiff's name and ID Number C/ 'tf o.

Place of Confinement ^ n

case no. iq-oon ce(Clerk will assign the number)

V.

A. 6asu^ sqr, Ex. Al. APPLICATION TO PROCEED

IN FORMA PAUPERIS

Defendant's name and address

I, p\\'\A9f\ IllL. ^TOnJldeclare, depose, and say 1am the Plaintiff in the above entitled case. In supportof my motion to proceed without beingrequired to prepay fees, costs, or givesecurity therefor, I statebecause of mypoverty, I am unable to pay in advance thefiling fee for saidproceedings or to give security for thefiling fee. I believe Iam entitled to relief.

I, further declare the responses which I have made to the questions and instructions below are true.

1. Have you received, within the last 12 months, any money from any of the following sources?

a. Business, profession or from self-employment? Yes Q No \Zyb. Rent payments, interest or dividends? Yes • No 0T/c. Pensions, annuities or life insurance payments? Yes Q No \?±sd. Gifts or inheritances? Yes Q No Q^e. Family or friends? Yes • No \Zyf. Any othersources? Yes • No 0

If you answered YES to any of the questions above, describe each source of money and statethe amount received from each during the past 12 months.

2. Do you own cash,or do you have money in a checking or savings account, including any fundsin prison accounts? y^

Yes • No 0

If you answered YES to any of the questions above, state the total value of the items owned.

AATCIFP (REV. 9/02)

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V.Do you own real estate, stocks, bonds, note, automobiles, or other valuable property, excludingordinary household furnishings and clothing?

Yes D No H

If you answered YES, describe the property and state its approximate value.

I understand a false statement in answer to any question in this affidavit will subject me to penalties forperjury. I declare (certify, verify, or state) under penalty of perjury that the foregoing is true and correct(28 U.S.C. §1746).

Signed this the day of AA\AA 1 ,20 _H\

AJ.aajIJuJ AlMJU 5^ USSigMture of Plaintiff ID Number

YOU MUST ATTACH A CURRENT SIX (6) MONTH HISTORY OFYOUR INMATE TRUST ACCOUNT. YOU CAN ACQUIRE THEAPPROPRIATE INMATE ACCOUNT CERTIFICATE FROM THELAW LIBRARY AT YOUR PRISON UNIT.

AATCIFP (REV. 9/02)

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F-»i&cl Ct*t*LH3 l

tfrvftfcTexas Department of Criminal Justice

STEP 2 J? OFFENDER' GRIEVANCE FORM

.OffenderName:/U'fW/J' VfC flT^ftX, TDCJ# S^lffUnit: fMSX MrAu Housing Assignment: ftJ-l-4>Unit where incident occurred: f&W UrtAnA

W<Li \{-io~i<>

OFFICE USE ONLY

Grievance #:C^t At^JA 1 i *-) <-) I

UGI Reed Date:

HQ Reed Date: AUG 2 8 2013Date Due: C_JU O^tJJ .Grievance Code: /Yv^yi

Investigator ID#:

Extension Date:

115/

You must attach the completed Step 1 Grievance that has been signedby the Warden for yourStep 2 appealwuae 0 & ZUijaccepted. You may not appeal to Step 2 with a Step 1 that has been returned unprocessed.

Give reason for a;on for appeal (Be Specific). _ I am dissatisfied with the response at.Step 1 because..'<^—•". 'i.-i'.IJMJ«^a^*^ minium »i rr *..„•• ••

TH£h.^ ufM 4, fatfl- '

v& -0*5*4fll*tf*i*y- &p<vtTi jaj rm /Wfrfr ph&tpfM^*rU{ iisix**-™1L -

1-128 Front (Revised 11-2010) YOUR SIGNATURE IS REQUIRED ON BACK OF THIS FORM (OVER)

Appendix G

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\ '•'

Offender Signature: Cl^J/Atf.(\&AulJjUjLf

£ffl>Grievance Response:

-V' >

Date: flf-Z6-M\ • . : : ,

• •. v 1' i- .Major Disciplinary Case #2013033723 1i has been reviewed.-.vThe disciplinary charge was'appropriate * "jlijf:for the offense of assaulting an offender without a weapofi, based on the officer s report and testimony at,

I ~the4 hearing, and'the'giiilfy verdict was supported by a preponderance ofthe evidence^ All clue'process ±, ik£)\.\\^j*,» s *(requirements,were satisfied andTrie punishment assessed bythe Disciplinary Hearing Officerrwas-within^ ^ ym«ji"'"" ' *agen'c^ guidelines. No further action is warr&rited'inthiFmatte?.*, ••**.• »•' *•+* l -••- *»y-*-«»-

Sign^tiir^tUi^_A^PARKERv W^ V>A A,^L^ -VV^Returned because: *Resubmit this form when corrections are made.

LJ 1. Grievable time period has expired.

L_1 2. Illegible/Incomprehensible.*uJ 3. Originals not submitted. *

-Q-4.-Inappropriate/Excessiveattachments.* - —

LJ 5. Malicious use of vulgar, indecent, or physically threatening language.

LJ 6. Inappropriate.*

CGO Staff Signature:.

1-128 Back (Revised 11-2010)

OFFICE USE ONLYInitial Submission CGO Initials:

Date UGI Recd:_

Date CGO Reed:

(check one) Screened

Comments:

_Improperly Submitted

Date Returned to Offender

2** Submission CGO Initials:

Dafe UGI Reed: ' -'"* ?=»*<-•*»-=&••• f

Date CGO Reed:

(checkone) Screened

Comments:

Improperly Submitted

Date Returned to Offender:

3°* Submission CGO Initials:

Dale UGI Reed:

Date CGO Reed:

(checkone) ^""Screened-

Comments:

~—• — Improperly Submitted-

Date Returned to Offender:

Appendix G

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Texas Department of Criminal Justice

<1TFP 1 OFFENDER& 1 hiI 1 GRIEVANCE FORM

OFFICE USE ONLY

-DEC-ft-9 701*.

~^:s -artj--^i- ;*-,

Offender Name: ^1^1/ori 1&<l ftT/MLtt, TDCJ #^jjeg.Unit: P^TUt^fU.-S.jA/) Housing Assi?nnylitr5^3 12 ^}Unit where incident occurred: &H-$JI\AkA UKJiT

Grievance #:

Date Received:

Date Du

^Grieyance^CoOTTl

Investigator ID #

Extension Date

Date Retd to Offender:

You must try to resolve your problem with a staff member before you submit a formal complaint. The only exception is whenappealing the results of a disciplinary hearing. -Who did you talk to (name, title)? TjaJhAAre IlUl6TJu^cl) l,(1ffi f When? JA^O^ji?. -^-What was their response?; (J rtjIJAJ^Q flj . -: "• ' ' : ' • v ;What action was taken? U*H(tO/.»iOfrt

State your grievance in the space provided. Please state who, what, when, where and the disciplinary case number if appropriate

dm 4/1*/1^ 1 ApfuJiuifi Aaai^rifl.dilUM*. c\o^\J b^ Irjnifo, t)\\ur\ 'V\L• • ' x^u^r u*l*\ AcLfLnanX Tdmi rftu rtn AhnuT f/4£ / f.J.Tilrfl^J . .. f^f f —T-™ •• ^j^. — —i - — m- w^^*m m • ^t— i~t ~ • ••* —•—• n i — • t ^^ r • i ^ ~i n^ia ^m * • t rm nrrn—rn i > — ' -~

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lUvlTI-l Fulj AtunMuif Til ^AJ Hit IL4ij ^jliliiJ K=J".6 ilk ^J^T

Ofr^ 14no-* r'±m—^H4^^-^r^>^

1-127 Front (Revised 11 -2010) YOUR SIGNATURE IS REQUIRED ON BACK OF THIS FORM (OVER)

Appendix F

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*^~ '

• ...'*•

.?.' ••

•*•-•, -,

«•

^ < -^

'*.,

Action Requested to resolve; your ComplainV^AT TlitL ST^rE. CilukiTu £du«J6 Al8oI Me. THifi )ss

Lie.. .,._ • ^ ^ • i ,' \ •' " ; • ,,' , t

Offender Signature-HA.sid P(<UL> A fo%Lnj Date: ftJ&T[W-—

Grievance Response:

. * >» -' *.. r

: ». "v ; „„•. t k L "j» '•

._ ^

"» ,'/\

?• <

•\ V.WJ i\ - * t - .

)• .

v/ -) vi . •• • . j h i\. •,.i W i -5 T .iT/,.'«

•«.

. "- 1 t" I X! * ! , ; i * \ I \ i >i < "vmm ; <.•, '• ^i/ j v i 1 A

Signature Authority:"If you aredissatisfied with the Step 1 response, you may submit a Step 2 (1-128) to the UnitGrievance Investigatorwithin 15days from the date of the Step 1 response.State the reason for appeal on the Step 2 Form. . ........

Returnedbecause: " ' *Resubmit this form when the corrections aremade. _ " ' • "• *.' '

PCI 1." Grievable time period hasexpired*JCX> U'9 L\i\5

fi2. Submission in exceS? of 1 every 7 days. *

l~l 3. Originals notsubmitted. * i •,.

n 4. Inappropriate/Excessive attachments. * ' • 1

I"! 5. Nodocumented attempt atinformal resolution. * 4

n 6. No requested relief is stated. * '„•.., i » •ZZ \ ••<•;• i J ' ' ' > . •• -• ' 1 . I117. Malicious use of vulgar, indecent, or physically threatening language. *.

I~l 8."The"issue"presented is~hot grievaSle.

[~1 9. Redundant, Refer to grievance #

l~l 10. Illegible/Incomprehensible. *

n^l- Inappropriate. *

UGI Printed Name/Signature: "• ' ^ DEC 0 9 2013

Application:of the scfeening criteria for this grievance is not expected to adverselyAffect the offender's health.

Medical Signature Authority:

1-127 Back (Revised +l-=2Gi-G)-

_*-

Date:

OFFICE USE ONL,,UGI Initials:. &*->•Initial Submission'

Grievance #. _ _ .. .

Screening Criteria Used: /

^ZH^m2^'^ortasMi.»

Date Reed from Offender: VDEC Q. Q 2013^Date Returned to Offender: faJkL,0 9 2013t 1^-Submlsslon

Grievance #:

Screening Criteria Used: _

Date Reed from Offender:.

UGI Initials:

Date Returned to Offender:

3"J-Submlssion yci Initials:.

Grievance #:

Screening Criteria Used:

Date Reed from Offender: _

Date Returned to Offender:

Appendix F

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~i\L£l llHl M /^5/jO ftaC. 64-OT- /^Texas Department of Criminal Justice

==-?!»• .:«"<

cri^D 1 offenderd 1 Hil* 1 GRIEVANCE

Offenderjyame:-/l-t fot gy?L Jfl/l.fifly>ft-ffUnit: ESTpllfl. f !-(.<»• f)W«i„c Accic„^nffrUnit where incident occurred: InSfgJlo, (U.S. b

FORM

OFFICE USE ONLY

Date Received: pFP-'<t?1 7M3Date Due: nU^Cfi^

^o,Grievance Code:

'Investigator ID #: -^ yt?f^~Extension Date:

Date Retd to Offender: FEB 0 7 20H

You musty<>jes0ly^^ submit aformal complaint The only exception is when'appealing the results ofadisciplinary hearing. __ - ^ - ' --'— • — -^ ^.,..~ {, „.^K... -_".,",Who did you talk to (name, title)? Iu U/Kb XuxJM t-.Ji.yJ, f.tl.A Wh.n? fg-^3-IC5What was their response? (Jkli/A \fMi\U 1 ,Whataction-was-taken?->|~J(-k4-[/-U-lA^It4 •>- ,. ,,~. ^ ;

State your grievance in the space provided. Please state who what, when, where and the disciplinary case number if appropriatefliU> U-l*-U3 J H&\nTt<\ Til JiUU, An TH.h^rJ fW Um fr,^

|4 a A M t mTrrri ' ' ' ,r" ' >"-•• n»/ '^1 i» m hi ri/n( iW/w,n rimy

y^V',rl,^n';H'I rN<,ti) nt" 'i"/^"*" rl^ ' '/is.nE Emm a?-''•• 'u I. (*" Is .™*ft'" ,r •h j A'M' l!1 m-4-E"- ' -M *4- r"'*^~^,.,<rhyl ftM-nnmT -RIh Art ml-Wrt^ ,Hu Tilers ji..^wtAj;h, /wt

flpju, {'/•ru., Amah if iq.nilf "

j — ••—— — ••'•• «•••-• f^ll j 1 Iflrt AWi HJBil 1 I I |

«lifiXi) iftiufr].-*/ riJitr rut Pri,lurflnrlPH TUP \iLmiAlikMm^A,it /U jaJri,i,ii Fd.,^,m h HE miv ffioforlitifl-fw tun-mi* /i0[/irk;r

fi4tl l<me.i/ nr

- _ - , j ' ; -.~ ••...•-.,. « w*,*, i « i i i/ti-1 r iy|iu win .i.^. i irn^.--—f.l< IMvlAW^.

Mttf/ I rhln\X irUvi TVh' hill flMinnr 'm ^^•/^ ^,

1-127 Front (Revised 11 -2010) YOUR SIGNATURE IS REQUIRED ON BACK OF THIS FORM

Pi"g—1 <j •-»

(OVER)

Appendix F

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•^

s^-

•^

i - J.4-.J

M'

Action Requested to resolve your Complaint. &Mq^llldtl OjdKAMJttlbul STqh/L ^ill4<UAAS<L.

-. (\ $1 aaAolij j Abut*-Offender Signature Date: \3L\&&\ \3>g6rievance;Rcsponse: Wit.

Your complaint has been noted. Inmate Trust Fund (ITF) was contacted and states that $2.00

was deducted on 04/18/13 f6r a state order. Two civil orders were deducted at $2.00 each on

04/18/13. You have one federal order which was deducted for $8.00 on 04/18/13 which was

the standard 20% for federal orders and 10% each, for state and civil orders. The amounts

were properlywithdrawn. No furth'eractron'is'warrahleSr^^"~' ' "

Signature Authority: "^* " *V-X»^> " sTr" Date:If you aredissatisfied with the Step .1 response, you may submit a Step 2 (1-128) to the Unit Grievance Investigatorwithin IS days from the date of the'Step l'response.State the reason for appeal on the Step 2 Form.

Returned because: ^Resubmit this form when the corrections are made.

• 1. Grievable timeperiod has expired.IT! 2. Submission inexcess of 1every 7 days. *

l~l 3. Originals notsubmitted. *

l~!) 4. Inappropriate/Excessive attachments. -* • -• - •

O 5. No documented attempt atinformal resolution. * , a

L~j6. No requestedrelief is stated. * _ ;

1~1 7. Malicious use of vulgar, indecent, orphysically threatening language. *

M 8. The issue presented is not grievable. „

n 9. Redundant, Refer to grievance #_

l~l 10. Illegible/Incomprehensible. *

nil- Inappropriate. *

UGI Printed Name/Signature:

j

>. y

.r

Application of the screening criteria for this grievance is not expected to adverselyAffect the offender's health.

Medical Signature Authority:

1-127 Back (Revised 11-2010)

' 'H. . -* •**§f-

WARDEN BREWER

OFFICE USE ONLYInitial Submission UGI Initials:.

Grievance #:

Screening Criteria Used: _

-Bale Recd-frorn Offender:—- -•*=• ~ ~

Date Returned to Offender: •'

l^ubmissiQ" . UGI Initials:.-Grievance-^:-— . - ' ^--~- "—*•• - '

Screening Criteria Used: _

Date Reed from Offender:

Date Returned to Offender:

a-^H^mlSSiP" H .,, UGI Initials:.Grievance #: - - •

Screening Criteria Used: .

Date Reed from Offender:.

Date Returned to Offender:

Appendix F

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Pi'ltd oxlpiiif A<UL. £>3/»^//^

Texas Department of Criminal Justice

_^ ^OKFICEJJSE-ONLY_ ..„.

STEP 2 OFFENDER

GRIEVANCE FORM

Offender Name; AtX-xajlTX iilh feTbfiJl TDCJ # 5"q<i (obgUnifctSfUl*.

Unit where incident occurred: fcfrTtM-l

_ Housing Assignment:^ .t)*.^ Kj"^TZ>

Grievance #:

UGI Reed Date:FEB 11 2014

HQ Reed Date: FEB 1 3 ZDU

Date Due:

Grievance Code: —^ *-^

InvestigatorID#: A— \ OO'

Extension Date:

You must atiacJTthe completed Step J Grievance Tfuii*na~s been signed by the Wardenforyour Step~2 appVtl,accepted. You may not appeal to Step 2 witha Step J thathas been returnedunprocessed.

-3e-3 2Qtt^-

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/kjrl -p4^T IO% LJt'14 fol T/I^ji hltf £AlU 5TAT& CtartJ. AT H4fc Qf\K\yX\*A<l, : : ' - - "• -—

+

1-128Front (Revised 11-2010) YOUR SIGNATURE IS REQUIRED ON BACK OF THIS FORM (OVER)

Appendix G

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;r<t

Offender Signature: Q^J/Lt^ etfjjj ^JjM> Date: 0& / ibf t<fGrievance Response:

.«•' . . i -rm •

** • -V\ T^"

?'Ti

i.l * f t . Mf h -'if

Your Step,2 grievance has Leen investigated by this office.^ You were , . ^ /\ ,\appropriately advised at ttie Step 1 level. No further investigation warranted

» by this office. \ * ..".-.** i

1 I

7-Signature Authority:

. : t : » )- * < * F *'». *

Returne'd because: *Resubmit thisfarm when correctionsare made.

L3 1. Grievable time period has expired.LJ 2. Illegible/Incomprehensible.41 • * <

Lj 3. Originals not submitted. *

LJ 4. Inappropriate/Excessive attachments.* ' --,*....•.

• 5. Malicious use ofvulgar, indecent, or physically threatening language6. Inappropriate.*

> i

CGO Staff Signature:.

1-128 Back (Revised 11 -2010)

Date:-TV*7"

,OFFICE USE ONLY , , ~~Initial Submission CGO Initials: -

Date UGI Reed:

Date CGO Reed: •

(checkone) Screened

-Comments:— *m-wr=

Improperly Submitted

... ....— . . .*. .. —

Date Returned to Offender:

JS"1 Submission CGO Initials:• !,

Date UGI Reed: i l

Date CGO Reed: ,

(check one) Screened Improperly Submitted

Comments:— - --!.«--,-

Date Relumed to Offender:

3s1 Submission CGO Initials:

Date UGI Reed:

Date CGO Reed:

(check one) Screened

Comments:

Improperly Submitted

Date Returned to Offender:

Appendix G

J

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M

Texas Department of Criminal Justice

^ ^^ OFFENDER V '-STE

(Offender Name: AtTi/f gjj Utf . 3T7*Ul TDCJ^ fiCO/^^f Unit: EtegfU*<i4 Housing Assignment:U^ I-4^ )

Unit where incident occurred: \hltfpr\ApL-hA .

OFFICE USE ONLY

rfrT GRIEVANCETORM

Grievance #:

-Date-Receiv*<k-

Date Due:

GWevaiKe Code: _

Investigator ID #;.

Extension Date: _•_

Date Retd to Offender:

You must try toresolve your problem with aWaff member before you submit a formal complaint. The only exception iswhenappealing.the.fesyf fsj>f.a.disciplinary.hea'ring." __'" ^..1. --- ^"S-~"- *-Who did you talk to (name, title)? ?MlTi QA^VftJ . UAA(yA Tiki,jfifing MitS When? <?7-4X'l3What was their response?'MHJU^JP^vi Ki ^ >• V{- ^W^-,' -? >- ^i_Whataction was taken? M,AjKMfl</l-*iL1 - . — —

State yourgrievance in the spaceprovided. Pleasestate who, what,when,whgreand^tj^j^iplmaixcase.number.if appropriate,^

W ufUfU,tti fry. -p^*** ™ .fi^i^P^yl'A' **?• *yM- ptf^>»iA4^^i<»

Tt> ^. ir /ua rttz it j.utq rtjgjig .^ pfz rAP//;<>it«t~Cnrer nwrtx

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u* j\*j>fl»tf<t. fat* r fafii^l rrt fliii^ TMfl ftifwl* ^—7>i -A Ml*.c<ij.Tfl gfe^'ipt Tt& ptinAoiT,! /uA fiUtrk*—a\ nair t.ituk rtAeju* . s* ru,? rAP//;(>juj>r^nr ric^Y**

1-127Front (Revised 11-2010) YOUR SIGNATURE IS REQUIRED ON BACK OF THIS FORM (OVER)

Appendix F

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£t*-*j\ OT „0^» f\-0*- *• , o p ^

Action Requested to resolve your Complaint TM# \4pXumuJ itf imh ^/igtTti 4.^1 MiAelryyjfefcfltaOffender Signature: Qlrfj/ttzJ fXAl) jdjtfrU)

%Date: 'Off-o?6-ftg

Grievance Response: ., yw

J ♦ I A > 1* r ' <i '' V * *. « r jut-J. ' .1 i -! ! •P4

.^^^U p^^-~- *-%>^0^-^L^,.#^ I f •> ... s'V

Ki' ; > * * •>x<VA i A tn\ ?':;; r\ *i -U *_,. ; ,; jj "•-J

j t :' •» f»i 1,.-1

Signal Aut^:1^ P'^-^'f ' > * '.T^r It j,^'^ /I ^ - ^^If you arc dissatisfied with'the Step 1.response,,you may submit a Step 2 (1-128)to the Unit Grievance Investigator within IS days from the date of the Step 1 response:State the reason for appeal on the Step 2 Form. _ " *, *" "" ••• ' " „

Returned because: 'Resubmit this form when the corrections are made.

Bt^GtSvable-time peri?d has expired.1 P^';' AUG 26^2013 , lL_| 2. Submission in excess of 1every 7 days."-* -• x " ' ' -^<- "-•*"•'

[71 3. Originals nbt"subirtitted "j*1.'" x->>* .••*.(/ • * i "• '• >> £• i' v*ll 4. Inappr&priate/Excessive attachments. * «1 ' > ' ' ^ * L- •' >»' I » •

n 5. No documented attempt at informal resolution, t* >' • ~, -• . *, ¥ ' ••••• *.*: ». \ •'•♦. *

l~l 6.>No.requested relief isstated. * , ». , . , a, -v__ . ' ^ ii, '"," .-,!•.'. .-,4. / ( •) •;«;. i- t lI I 7. Malicious usS"6fvulgar, indecent, or physically threatening language. *•—•

n 8. Theissue presented isnotgrievable. ' *-- - • - t i i • . «». r

[J 9. Redundant, Refer to grievance #_

I

.1 \ 1 < «

f n,-, I

t . ' - ^n 10. Illegible/Incomprehensible: i, V* 'jti

[j 11. Inappropriate. -*

UGI Printed Name/Signature: '7/(L<L 'f^&J'JMismApplication of the screening criteria for this grievance is not expected to adverselyAffect the offender's health.

Medical Signature Authority:

1-127 Back (Revised 11-2010)

fiOii - l>i ' ' ( -'Ivf

OFFICE USE ONL

•.'2>)/J2A7*6<<rm'

Grievance #:

^Screening Criteria Used:f ^ < jj" ""IjXate Reed from Offender": t . j AUti L 6 2013j" Date Returned toOffender: AUG 2 $"2013t2^$q|>ml»iop * | UGI Initials: \

Grievance.*: __; .'"['*'• I : ' ' " . . .• ''*>.'Screening Criteria Used: — * *" * ^' > . f. » • r 1 ," 'Date Reed from Offender: ' ' ' ' O. .-

;Date^Returned to Offender: »• '

a°»-SHfemMi2ll UGI Initials:.Grievance #:

Screening Criteria Used:

Date Reed from Offender:.

Date Returned to Offender:

- ")

Appendix F

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PilkilLlJi-Ul AujUVMj \AAtV. -QL l£&l~!±,-4&'

Texas Department of Criminal Justice

STEP 2 OFFENDER

GRIEVANCE FORM

OFFICE USE ONLY

Grievance #P^Qf *£ 0/ cO RfcUGI Reed Date-NOV 18 2013ug NUV 2 12013HQ Reed Date: j_

Date Due: la-33Offender Name: AiffUlA \(£jL, fVfoU<^ TDCJ #5^1(^5VS11CI1UCI liaillC. f^\ ' 1 r»j^~^-i » •«~»w W" Bx> -^^ 1 1>UU ffWI I ~WM v,..v....vwv.™v. :—~

trnit: X?)TeJA<L 1iluJTfjkSifl^usingAssignment: U«S>A. fl'312 L^Te^l^investigatorid#: _| ~\(?oHUnit-whereincidentoccuiredi-ir/^TMrAiii^LJ-lLl-iT• --• —

Grievance Code: 57?

Extension Date:

w

You must attach the completed Step I Grievance that has been signed by the Warden foryour Step 2 appeaW&Tbe uaccepted. You may not appeal to Step 2 witha Step 1 thathas been returnedunprocessed.

Give-reason for appeal (Be Specific). 1 am dissatisfied with the response at'Step ] because...

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T-'viG u\i\iih.i | mttttc^ HE nnitL^csHi^^n^ru^ rtt Mm Mirks AfTVfc

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rjirJ<Li IUi| fvlutf.iUii fl»^l £i1lt<U^ vU^KJiImA LLA>i^<T/^r /Vf'TillM <M*.i)

[-128 Front (Revised 11-2010) YOUR SIGNATURE IS REQUIRED ON BACK OF THIS FORM

•"—* '

(OVER)

Appendix G

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<f*

;.'i-f '• » »/"iM

"", v tfiffo•

Offender Signature: && AjiA a/tJ>J ^/ Z/QtUJ Date: J/~/?-MA, ...iT.: *-C"'

Grievance Response:

Your Step 2 grievance has been investigated;by this office. You wereappropriately advised at the Step 1 level. Your complaint is noted. Nofurther investigation warranted by this office. - ' -

i i ••«. *•* v-

Returned because: *Resubmit this form when corrections are made.

LJ 1. Grievable time period has expired. * .

LJ 2. Illegible/Incomprehensible.* -

D 3. Originals not submitted. * -LJ 4. Inappropriate/Excessive attachments.*

" '^v'r' r^%x'5. Malicious use of vulgar, indecent, or physically threatening language.

LJ 6. Inappropriate!*

CGO Staff Signature:

I-J 28 Back (Revised 11-2010)

t^t

OFFICE USE ONLYInitial Submission * - CGO Initials:-

Date UGI Recd:_- I

Date CGO Reed:.

(checkone) Screened

Comments: '

.Improperly Submitted

^Date-Relumed to Offender—^= <=-•-*-

2"^ Submission

'Date UGI Reed: _

.Date CGO Recd:^

(check one)

Comments:

^ CGO initials:.

Screened

Date Returned to Offender: _

3°* Submission

Date UGI Reed:

Date CGO Reed:

(checkone) Screened

Comments:

Date Returned to Offender:

.Improperly Submitted

CGO Initials:

.Improperly Submitted

Appendix G

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fteJfik£K.S3.l£LIJ41 / Q5 /.*o ( .HIlTexas Department of Criminal Justice

TEP1OFFENDER

GRIEVANCE FORM

Offender Name: AtETu 0f V\ JUL. i*STUld<- " IPGJ-#-^SJ^3^^Unit: PAST UzAM Housing Assignmeikli .fa /) - vO-3 17Unit where incident occurred: V^A(SX W&kA ^

OFFICE USE ONLY

Grievance #:<gpMAR 2i> 2014Date Receivedeivcu, *

Date Due:

GrievanceCode: _

Investigator lb"&: 1 *- tr*^

IExtension Date:

Date Retd to Offender:

Vou must try to resolve your problem with a staff member before you submit a formal complaint. The only exception is whenappealing the results ofa disciplinary hearing. ". * '•*•'* MWS \\\ lAAS ,_Who did you talk to (name, title)? ^)\lT. .nftftltixJ • KAfiADa. iUJM pSOhJ When? , 01" V6"V3What was their response? UhJ)U MOf>tJ li.l ^_: 'What action was'taken? (Th1\L KJflkJhJ ~

State your grievance in the space provided. Please state who, what, when, where and the disciplinary case number if appropriate

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4^f>hi ynmi/ygnTf i falas l/^AniUr Til k>k lm( npfrp^ |/k^| r»n tii illi\U;mA Hi. OAAop\nr\ X\Xia\X \\A\A tii.". -ifWV?j_j^i i._ift-jd. &3i4*.rt-Tlfo7 •

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±M.| lA^Jiil Mi/J U&^rJ A)Ani\LX H^. mfoVmni 4*/I TliM t iKAg)s SaFim \Aui Til rj^gj>J^ Til 5^ in tUm ^ All nA 1 f>w./1^j^i P^ulkJ

-127 Front (Revised 11-2010) YOUR SIGNATURE IS REQUIRED ON BACK OF THIS FORM

•""a

MAK-a-5-™

(OVER)

Appendix F

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•w i •n

A,d.nRequeS,gd,o,MQlvey.urC,mpl,tn,T|J- ^j, ,„, , ftp ^ ( ^ft fl,,) UqH-^MAOC

Offender Signature: (\AtAJ*l JtiJ AtiHAU)ore: L/jaL/.)nse: / JGrievance Response

Signature Authority:

Date: 0% ' <3L - l>3

Date:

if you are dissatisfied with the Step 1 response, you may submit a Step 2 (1-128) to the Unit Grievance Investigator within 15 days from the date of the Step I response.State the reason for appeal on the Step 2 Form. *

Returned because: *Resubmit this form when.the corrections are made.

1. Grievable time period has expiredMAR *> 5 tUH1,2. Submission in excess of 1every7 days. *

l~l 3. Originals notsubmitted. *

1 1"4" Inappropriate/Excessive attachments. *..BjS. . ^_ ^.^ _„_ .

l~l 5. No documented attempt at informal resolution. *

n 6. Norequested reliefis stated. *j-! 7. Malicious useof vulgar, indecent, or physically threatening language.

n 8. Theissue presented is not grievable. "* " ~™

l~l 9. Redundant, Refer togrievance #

f~l 10. Illegible/Incomprehensible.

n 11. Inappropriate. *

UGI Printed Name/Signature:

Application of the screening criteria for this grievance is not expected to adverselyAffect the offender's health.

Medical Signature Authority:

1-127 Back (Revised 11-2010)

OFFICE USE ONLInitial Submiss

Grievance #:

^.Screening CriteriaJJsed:.

sijx) . I JjQI Initials:

Date Reed from Offender: MAft ^ 5 £""'Date Returned to Offender: MAR & 5 2014 'a^Snbmission

Grievance #: ~~" "^

UGI Initials:

Screening Criteria Used:

Date Rccd from Offender: _

Date Returned to Offender:

B^Snbmlssion

Grievance #:

UGI Initials:.

Screening Criteria Used:

Date Rccd from Offender: _

Date Returned to Offender:

Appendix F

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C^T17T> 1 OFFENDER^ 1 ILJr 1 GRIEVANCE FORM

Offender-Name: AX&h&d~ lu—SXbjiMh- ^TB&J#-S^^^ --V™t:&0$MlM Housing Assignment: K<&:'fo T&-A\2Unit where incident occurred: k/$?ffifeffyffi.^

OFFICE USE ONLY

Grievance #:

Date Received: -MAR^ ? ^"

Date Due:

Grievance Code: _

"IiTvestigator'IlJffr

Extension Date:

Date Retd to Offender:

\.T

You must try to resolve your.problem with a staff member before you submit a formal complaint. The only exception is whenappealingthe resultsof a disciplinaryhearing. •*-•Who did you talk to (name, title)? Afajbflgffi&|ffiEffi. JUti&ljl.What was their response? Ll&0 UKJDUJK}

i'fiWArtdjtJL)- When? _mjU^3j-Mjj3

- -Whataction was taken? t>HJi/»JDUJm

State vour grievance in the space provided. Please state who, what, when, where and the disciplinary case number if appropriate

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*U&

1-127 Front (Revised 11 -2010) YOUR SIGNATURE IS~REQUIRED ON BACK OF THIS FORM-

\T

"(OVER)

Appendix F

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•^Wt

^k.

'4 ^.-.wil

..<.,^. ° ...» i . *vj\

j.iiU <f k->

>.„»-•»••:-, it-Ai

-- >w.Action Requested to resolve your Complaint, j ^^ T| l/^J^) flf /lit M^l f R^teSi*^

Offender Signature: /l/<^/ /LjA cJi t ) A/h^mGrievance.Response:-^ ^ ~=£.-.f^j- >-—m—.:• *^-<—

Signature Authority:Ifyou aredissatisfied with theStep i'response, you may submit a Step 2(1-128) totlic'Unit Grievance Investigator within )5days from thedate oftheStep J response.State the reason for appeal on the Step 2 Form. .

t '•

Returned because:

jf| I. Grievable time period has expired. >Ji£$ \1 t-UrrM 2. Submission in excess of 1 every 7 days. *

r~l 3. Originals notsubmitted. *

Q.4. Inappropriate/Excessive attachments. * .f~i 5. No documented attempt at informal resolution. *

•0-6. -No:requested=relief-is-stated:-^-r. -jp--»m»t* —-. ^^g=y^-"-T----- ^t-.^-t~1 7. Malicious use of vulgar, indecent, or physically threatening language.

1~1 8. The issuepresented is not grievable.

1~1 9. Redundant; Refer to grievance # . ]

l~l 10. Illegible/Incomprehensible.

|3 11 •Inappropriate. *

UGI Printed JVame/Signature:,

*Resubmit this form when the corrections are made.'I

MAR 1 7 2014

Application of the screeningcriteria for this grievance is not expected to adverselyAffect the offender's health.

Medical Signature Authority:

1-127 Back (Revised 11-2010)

X

{f>k&Jjo$] n//^fj^.. vvi i /.... ••?.•Jt.t^fe*'^-^-

bvA >*•'.'* ~i^

i

Date:

OFFICE USE ONLYy£)Initial Submission ( UGI Initials: ^¥^J

Grievance U: & ff> N'/ / /I?^(#Screening Criteria Used". _ I

r»*Date Reed from Offender: U^" .'nift"fratc Returned to Q?feii(Ier:p ftift '*> • •"2°J-Submission * . UGI Initials: <Grievance #: :

Screening Criteria Used: .

Dale Reed from Offender: -

Date Returned to Offender:

l^SjjJuniSiiSJl UGI Initials:..

Grievance #:. ,

Screening Criteria Used:

Date Rccd from Offender: _

Date Returned to Offender:

Appendix F

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flg<L. H-&-*$•- KU^XiJ^3^iB^ -FXi-Cj

Texas Department of Criminal Justice

nTl7D1 OFFENDERS 1 SLr 1 GRIEVANCE FORM

Offender Name: AlC^gg] l&^ ti>T6<iJg. TDCJ # ^fa UL>SUnit: feffifcjU*. Housing Assignment: Miflttfl. ifl-^UUnit where incident occurred: &5T'gJ,jfcJ

OFFICE USE ONEY-^

OCT o 2 2013Grievance #:

Date Received:

Date Due ll-U-H^SI g*Grievance Code: l

Investigator ID #:.

Extension Date:

f^S-o

Date Retd to Offender: NOV 0 5 2013

35^w.r>qqNyy^g^^^^

You must try to resolve your problem with a staff member before you submit a formal complaint. The only exception is whenappealing the results of a disciplinary hearing. ' 'Who did you talk to (name, title)? J)h,\xA<l*X.* - lIFfi'tAl teg. f UJlUrdfcM When? cft-lH-k^What was their response? URjIXxjOl*/*^ — — - - '

^W-hataction-wasHaken?Tt^tfRx^2Sr

State yoiir grievance in the spaceprovidedT" Please state who, what,~wheh7wh"efe andth'e dlstiplin'arycase number if appropriate

r^fyVbX\At\)\k tiMiT* ?>n Hut W. k4okm,imj<1 LiFr^l;\/^^ rip tW\ Jinn

^ £

iftjq R5k. fe *'-" r—^ •*-'-H f- -1 ^ """" ^"- ••"*'xw Upmif1

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ftJQf 1C

JU

532 +

fg^pCl Tjl -p^. £ar^U.^a»«)ir.| J i>< &i,AuA-eA T>f7~, (Ud Win TT4il^/xfVilkt fl^yl T7^. [dUnAf\SUAAi{ dnt\*A ilttiCeu tUuS !4iCi<fo

ElMed 5llT, iOAftki-B-iflay) Rof.l flaT (nfH/lf

^n^^T.i

iip/i;pTt-rrr-mi^sa-T-r FlT?r /i ^stc

£^r<?.VAAlgj^ i^ilAlKA

d*i /Ik /ihnur n^ ny-ad-v3t mU.fo. niu€. rf^. Fi^r t4-/wi UittiT InuT k<Afgj^rJ KJA Vl(L^|^o/o^^. I1C n4,7 i]^i^v;^i^g.. ^\l

1-127 Front (Revised 11-201-0)-^—YOUR SIGNATURE IS REQUIRED ON BACK OF THIS FORM

CTEU6 CAciuiUAl lAulS)

(OVER)

Appendix F

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'. y

Action Requested to resolve your Complaint

Offender Signature: Qa ^k A.A d <~(J.U /QAuSl^^

•j ~fci\i~i*&\-'"rife i/Wn^t nf /ill i/Utj k/tiss

GrievanEeTfesponse:" iDate: Jg/3//3

Your complaint has been noted. Estelle Unit property officer returned the property that was sent from

Eastham to you and you refused to sign the PROP705. Eastham unit was contacted and provided

documentation showing that several items were confiscated including books due to ownership questioned.

This is within policy. Confiscated property is not shipped to other units. No further action is warranted.

WARDEN LACOX —"

Signature Authority: Date: /&/S//3:/p1 response.If you are dissatisfied with the Step 1 response, you may submit a Step 2 (1-128) to'the Unit Grievance Investigator within 15 days from the date of the Step

State the reason for appeal on the Step 2 Form.

Returned because:

[~1 1. Grievable time period has expired.'1LJ 2. Submission in excess of 1 every 7 days. *

f~l 3. Originals notsubmitted. *

I I4. Inappropriate/Excessive attachments. *

'Resubmit this form when the corrections are made.

l~l 5. Nodocumented attemptat informal resolution. *

II 6. No requested relief is stated. *

I 17. Malicious use of vulgar, indecent, or physically threatening language. * .

f-1 8. Theissue presented isnot grievable.- —=^ - •• ~-~ • "--f ' ^ h^tp^. i. ->.: .

n 9. Redundant, Refer togrievance # "'

II 10. Illegible/Incomprehensible. *

Q 11. Inappropriate. * s

UGI Printed Name/Signature: •

Application of the screening criteria for this grievance is not expected to adverselyAffect the offender's health.

Medical Signature Authority:

1-127 Back (Revised 11-2010)"

OFFICE USE ONLYInitial Submission

Grievance #: •_

.—Screening Criteria.Used:

UGI Initials:

Date Reed from Offender:

Date Returned to Offender:- •_

l^SHfrmissjgn UGI Initials:.

Grievance #:

Screening Criteria Used:

Date Reed from Offender: _

Date Returned to Offender:

^SpbrolSjiyn ^_^_ ..^.UCIJnitials:.Grievance #:

Screening Criteria Used:.

Date Reed from Offender: _

Date Returned'to Offender:

Appendix F

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"~*Tefxas Department of Criminal Justice

STEP1~ OFFENDER^""

GRIEVANCE FORM

Offender Name:4) fltLC) \tJL £)TO Kit TDCJ # S^S^S"Unit: Lj4:ST14/IK4 Housing Assignment; U-^ I—*f

Unitwhere incident occurred: l^AS I ItA M

OFFICE USE ONLY

Grievance #.: C&/3 / 9 7 $ f./ _Date Received:

Date Due:

AUG 0 9 2013

Grievance Code:

Investigator ID teJ^b^b ^Extension Date: h)*\KJ

Date Retd to OfTender&UG 2 3 2013

You must try to resolve your problem with a staff member before you submit a formal complaint. The only exception is whenappealing the results ofadisciplinaryhea^ing-_ ^* ^V"'. **"••• •*•' ~* ""* ""*"/?" *4Who did you talk to (name, title)? fJ«J tT( 1> D ,Gi ) .; HJArtQ(LlL) VJdil When? lTtf - D? - 13

-Wh&t^s-thgjfreiiptnissT-l'-JidliHL^fY^ i I"—^What-action^as-taken?^^lbtlL=i44^y^fabM^-- ?f.

State your grievance in the space provided. Please state who, what, when, where and the disciplinary case number if appropriate

Firulr TlUr Ha^^i tin tu~ VW> yAyr>'rui ai/a*/i3 A^n,^)Tte, AT Hll-VifU Up UArJi A PAls*.-iftiy)i'1ivr /'mif juMtSf nl V^\t\6ir\OArt. llE flraTEf] AT TU," UtfUw.^fl TUilT UP fteii migT UiT iu_ ,l1MaT£ UiU^S ThliC^ iriiTfel M/) fi^T /Uirl TUiT iaIKJ/ffl. Min/^

state ujo^t imatS nriri}iij. /Uvl.'iiMcU iuoa^h ri-kr to*. iWJj/i

N/'A.i^ ifi.l^ \aa~?m>A ilte > Ph-hAa. FAL^Wr- ttJ.fti'luTfi ,

1-127 Front (Revised 11-2010) YOUR SIGNATURE IS REQUIRED ON BACK OF THIS FORM (OVER)

Appendix F

A

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* -^ - .-> . J

\J.\ • "K

-Lr)

\ '

Action Requested to resolve your Complaint.BUT TUP ^p.Ttiu.i .IF tU^ ssTAn/Tuft j/1 A~4

Offender Signature: &1jLaJ doc) ATj&uI^ - _1_. * . _Ii±_ Date: -life^ O^ ~ 13

Grievance-Response:*•- »«•. I, i

Date: AUG 2 3 2013imay sS^ta Step 2(1-128) to the UnitGrjeyance Investigator within 15 days from the date of the Step 1response.'

Returned because: - 'Resubmit this

• 1. Grievable time period has expired.• 2. Submission in excess of1every 7days. *• 3. Originals not submitted. *

• 4: Inappropriate/Excessive" attachments." *^ T- '" - --=•*-• •=---*=•--Q 5. No documented attempt at informal resolution. *Qtf. No"requested relief isolated. •*=- ^=~-s^2^ --- -—- -^- _-. ..

Q 7. Malicious use of vulgar, indecent, or physically threatening language. *• 8. The issue presented isnot grievable.n 9. Redundant, Refer to grievance # -_ •O 10. Illegible/Incomprehensible. *n 11 •Inappropriate. *

UGI Printed Name/Signature:

lie corrections are made.; ^

Application of the screening criteria for this grievance isnot expected toadverselyAffect the offender's health.

Medical Signature Authority: ,

1-127 Back (Revised 11-2010) f -- • -

OFFICE USE ONLYInitial Submission UGI Initials:

.Grievance #: _J

Screening Criteria Used:

Date Reed from Offender:

Date Returned to OffenderT" "~ " "" "~

l*^SnliiniSSifla UGI Initials:.Grievance #:

ScreeningCriteria Used:

DateRccd from Offender:

Date Returned to Offender:

a^SHhmissiim UGI Initials:.Grievance #:

Scr~e"ening~Criteria"Use"d:J""~

Date"Reed "from Offender:"_

Date Returned to Offender: .

Appendix F

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~6A[££i\(Lc\ Mim.i±nfcTexas Department of Criminal Justice

STEP 1OFFENDER •

GRIEVANCE FORM

Offender Name:* Mfrlta¥*H** rvVft lKi)^TDCJ#^^dgg6Unit: P5TPJ.U. l_ Housing AssignmenfTTXrV. tfl. lQ- o? IUnitwhere incident occurred: P~/*i^T 1-1 Ah .4

OFFICE USE ONLY

1 VGrievance #: -

Date ReceiJeP-4^fc-H*-4Q^

Date Due:

Grievance

TlnvestigatorTiy

Extension Date:

eCofc? ^*4fei-T^-:f4^-

Date Retd to Offender:.

You must try to resolve your problem with a staff member before you submit a formal complaint. The only exception is whenappealingthe results of a disciplinaryhearing. . f\Who did you tali to (name, title)? UlQlT CLLlvUf.) LUflfrtcklU 1QU4What was their response? {|KJ 1/ RJfl M) Kj s :What-action-was taken?.—1-1 HM-l/^H-JfJtdtJ-H-1-

? fl3-dY-l3When?

State your grievance in the space provided. Please state who, what, when, where and the disciplinary case number if appropriate

n»in* AW\mx nte iK/ok/ irt /I -KyUJn* iAxfc<)l/d<d^q 14<L4*imij ii )MA !4»Jd 11m fj^VL Kill. 3i1i3 L1331 23 1 /iT MI4;m4 M W P.lfo.mil ii )ma !4»Jd 11mj fj^VL ki»1. 3i1l3 L1331 23 1 /It MI4;m4 QxS \M Mb

h(^ (UlUd TH ilii/i 1A fartfiia Pi\i\0*MK\\k\rt A Fi<iUr Ftof I4dfyopm Hii x\aaj i/W, i\Aur\ nli tn/as/ts ^niAd i:'rs nr u)M-

l4i~ ST&Terl Ax TUi-: M^^-'"-»t-tr^iXJ^-.SgaL..x^ UjU^.j^iUtUJ.uiJfc-fii:h>iri;rlf^ Ri41k

iMA rmiUATC-Uin-tfA fi\/WS /4mi1kh4 TUlmli Any-! Tl4i^ fSTTiTP.k^lufTliiAMmirnut A15A \i\\A\oiA pAtMft TWa* TU' ifliVttjYilu \Aat \ T)4-

i«i lil/kS'(I'm'tHi]*. In^Hn^ ir£0-7/HI 13 r M113 Fijn^i ilu.'iTii ite rMti

-pK.(j).l4T-inll^

Tl1 A Q-5 ^T&Tii.S-l.4i1iilfWlj< fSimff. rMUT TiM< r\/i- iflrrtf.-3livp^prJ H4M TU^^l i6 miT^iVk XX2A \uwiui x\Af~ \l\il\-\ hi/ 4LlFEr-mfti. fiV)«. lUirl TUiAT i'idU \S\l\ mil Tu>i(0^1^^ h 1 flJJiAwiWl HJm

Ti4tL iAi6M^)liKwM'l'y^ik /Ak^J puMQC\i\«ii\ Fiiu Llffi^irJi^ ' tliliksm' inpt^i-nrsc ing-^Pliip-iiniu FHk-uH4i/j4 I. h.)WS LWa^A A+A E1<j^1-127 Front (Revised 1.1 -2010) YOUR SIGNATURE IS REQUIRED ON BACK OF THIS FORM (OVER)

Appendix F

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a npt-puis*. [r flmn. nuju.Fiiwi, tut- ^^i^^JMsiPi^^ruiui-L^^-it»1 tt4*t U1HA \AL\r\ llm Hg/ia /1«4 Til iflgrinuuuLir r f>l4iinld Id*.

Tiupml^ IflflMisL Inriro nltj<L IrtrtvH il^i iU-i X\*\{\vi.rt()eii~0\AtLiA

Iminimi /Wl EdPiftMili: it 11,17 Mkife^i1h/<

J i*^Action Requested to resolve your Complaint.

OJidjyJ <OujJtihWOffender Signature: ^^kflJLXJl CMS SVJUJrKV Date: fld'/j*/ / </•^Grievances-Response: **^7-j

Signature Authority: Date:

If you are dissatisfied with the Step 1 response, you may submit a Step 2 (1-128) to the Unit Grievance Investigator within 15 days from the date of the Step 1 response.State the reason for appeal on the Step 2 Form.

Returned because: 'Resubmit this form when the corrections are made.

t71 1. Grievable time period has expired. MAR J. 3 201*\V\ 2. Submission in excess of 1every 7 days. *

l~l 3. Originals not submitted. *

n 4. Inappropriate/Excessive attachments. *

I"") 5. No documented attempt at informal resolution. * , ,

£m6. No requested relief is stated. *MAR jl 3 Z014 fI~~l 7. Malicious useof vulgar, indecent, or physically threatening language. *

n 8. The issue presented ishotgrievable.

f~l 9. Redundant, Refer togrievance #

n 10. illegible/Incomprehensible.

Q 11. Inappropriate. *

UGI Printed Name/Signature:

» *

Application of the screening criteria for this grievance is not expected to adverselyAffect the offender's health.

Medical Signature Authority:_

1-127 Back (Revised 11-2010)

OFFICE USE ONLY/£>Initial Submission UGI initials: Stf-^*

Grievance #: -ZQ /Vj / 0 Ol Q?Screening Criteria Used: f C^ nfltA

"Date Rec'd from Offender: .

MM 1'Date Returned to Offender:

_2_°±£g£jnJ2Sion uai Initials:Grievance #:

Screening Criteria Used: _

Date Reed from Offender:

3ZM

Date Returned to Offender:

l^SubmijsiQn (JGI Initials:

Grievance #:

Screening Criteria Used:

Date Reed from Offender::

Date Returned to Offender:.

A.

Appendix F

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Texas Department of Criminal Justice

STEP1OFFENDER

GRIEVANCE FORM

Offender Name: A1 fcm f_\ \(LAfSXb ft )L. TDCJU-gtlJ t^U5Unit: ££>XdA\(L Housing AssignmqrffTU.S. tfl. tfl- 2lUnit where incident occurred:-fc^TQJ.l(?<-^.. .

OFFICE USE ONLY

Grievance #: a%.A,

Date Received1

Date Due:

Grievance Code: 'c'/ •• 7 ^•xfr

Investigator ID #'

Extension Date w

Date Retd to Offender:. >i

You must try to resolve your problem with a staff member before you submit a formal complaint. The only exception is whenappealing the results of a disciplinary hearing. . . _. ,.Who did you talk to (name, title)? JUil-* tfUL \U ~(Lirt."ftl ^ ltL/\Tl OMit- (Ll4i iI- When? Qg i I *T

'What was theirrespnfise?•j-J^j}/HJflXfl^ ^A . 1

Whataction wastaken? (J frjk, Hl^tVi j

Please state who, what, when, where and the disciplinary case number if appropriateState your grievance in the space provided.

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aucteM

nilhj HP/ A«rJ/4^riffrl/H)/1>./| THE -Artf if3li*jMrt<j-rM.<?. Atir)

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i\f.t\AArUr\ T)1 A,~4 ?sXHA< iS IOij THE 1iuMX-OlAfiSi fiC ATi&niOftk A* j71m~ A, ^1 Tt4ft a im >ts v/; IIV -r jijtitjOi it&ja- \Ko ^iltudax-J-

-ftTifl-M- h\A^ TkrpwpiM \n<cj?^M/)niAtu iniu.6y\<rutitif\ til)"au

srfc|«

I-l 27 Front (Revised 11-2010) YOUR SIGNATURE IS REQUIRED ON BACK OF THIS FORM (OVER)

Appendix F

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* V

s*-—V*

;v-^

^4^ *r

.tv\W

,«\Q

vw

ActionRequestedtoresolveyourComplain,TUAr f ^ ^UwJ Tl1 ^-1 ffflUi id J, <•WA- 1 JOAVrfJ.tllUC'

Offender.Signature.^UtyV-/f-ffvJw^/:^-^-^^^

^-Bate^-^^/^g-^/^^-

Grievance Response:

I S » \

1 '. 1. •

H| ..> '

1 .' I .* f

SijnatureAuthority;'1 ' * "^ ' ' ' '• > ^t

Date:

If youare dissatisfied with the Step 1 response,')oumay submit a Step 2 (1-128) to the Unit Grievance Investigator within IS days fromthe dateof the Step 1 response.State the reason for appeal on the Step 2 Form. . , -, v. _ ,

Returned because: ♦Resubmit this form when the corrections are made.

yj 1. Grievable time period has expired. ll*t» tL 4) Qiwvtl~l 2. Submission inexcess of 1every 7 days. * • *> •\_/M 3.; ^gmalsnoU.ubmitted.lJf..k. ..^ •» -p-*"!-^ r^~

l~|-4. Inappropriate/Excessive attachments. *

r~l 5. No documented attempt at informal resolution. •- • r] ' . >f~l6. No requested relief is stated.** -,--.. '-. . v - "M .

r^l 7rMa\icioususe-of vulgar: indecent-or physically threatening language. - *•

[~l 8. The issue presented isnot grievable.

LJ 9. Redundant, Refer to grievance # ' •* ' ." ;

II 10. Illegible/Incomprehensible. *4 1 , ^ «^ i *, --me. '

Q 11. Inappropriate. *

UGI Printed Name/Signature:

Application of the screening criteria for this grievance is not expected to adverselyAffect the offender's health.

Medical Signature Authority:

1-127 Back (Revised 11-2010)

•\:

• ••«-•= »

r

\ r

N

. \

OFFJCE JJSE ONi;"Initial Submission , ^ UGI Initials:

Grievance #

Screen inec^u<!n/*-tETig 2Qg-'Date Reed from Offender:

t * » • *J DateReturned to Offender

^"^Siibmislion"" -Ft ^~

Grievance #:

Screening Criteria Used: _

' Date Reed from Offender:

, I

UGI Initials:

-Date Returned to Offender: r

^Submission UG] initials:Grievance #:

Screening Criteria Used: _

Date Reed from Offender: .

Date Returned to Offender:

Appendix F

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( &•

Cn)

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Vo IAv/ r-f

INMATE CORRESPONDENCE REPLY

To: FILE DATE: 04/15/14

ALFRED LEE STONE # 599665 CAUSE NO. : 14-0076

ESTELLE UNIT COURT: 349™264 FM 3478

HUNTSVILLE, TX 77320

Dear: MR. STONE

We will need a notarized copy of your Inmate Trust Fund or a court order to preparethe copies you requested at no charge to you.

_X_ The following documents have been filed in the above listed case. File-stampedcopies of the documents are enclosed.

*ORDER OF DISMISSAL

Today, the transcript of your Petition for Writ of Habeas Corpus hasbeen forwarded to the Court of Criminal Appeals.

Enclosed you will find a set of questions the Judge has ordered you to answer.Please fill out the form and mail it back to us.

Other:

All further correspondence should indicate the above Cause number.

By: r\€Hte4+ IjUfltn, Deputy District ClerkHouston County

Po Box 1186Crockett, Texas 75835-1186

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voft\'l tf

CAUSE NO. 14-0076 <K tyfc$o

ALFRED STONE, 3 IN THE DISTRICTXOUR'% % ^#599665 b \ <£- *':>

VS 9 349th JUDICIAL DISTRie^,

A. BASKIN I HOUSTON COUNTY, TEXA^<*>.

ORDER OF DISMISSAL

On April 15,2014, Plaintiff filed The Texas TortClaim Action alleging four causes ofaction.It isobvious to the Court that this civil action is notbrought under the Family Code and isa causeof action governed by Chapter 14 of the Texas Civil Practices and Remedies Code.

The Court finds that the plaintiff failed to file an affidavit relating to previous filings as7"required by section §14.004. Plaintiff failed to file a certified copy of the trust account statementas required bysection §14.004. Plaintiff failed to file an affidavit relating to grievance system asrequired under section 14.005. The Court finds the claims were filed after the period prescribed insection §14.005. The Court finds the claims to be frivolous or malicious.

It is hereby, ORDERED, ADJUDGED AND DECREED that the action of Plaintiff againstDefendant(s) be dismissed without prejudice.

It is further ORDERED that the inmate pay an amount equal to the lesser of:

1) 20 percentof the preceding six month deposits to the inmate's trustaccount; or

2) the total amount of court fees and costs charged to the inmate in this cause.

In each month following theimonth in which payment is made above, the inmate shall payan amount equal to the lesser of:

1) 10 percent of that month's deposits to the trust account; or

2) the total amount of court fees and costs that remain unpaid as charged to theinmate in this cause.

Such monthly payments shall continue until the total amount of court fees and costs arepaid or until the inmate is released from confinement.

The District Clerk shall forward a current cost bill, a copy of the Plaintiffs original complaint,and acopy of this order to the Texas Department of Criminal Justice Litigation Support ProgramThe Texas Department of Criminal Justice shall withdraw money from the trust account of theinmate in accordance with this order and shall hold the money in a separate account. The TexasDepartment of Criminal Justice shall forward the money to the District Clerk of Houston County onthe earlier of the following dates:

1) the date the total amount to be forwarded equals the total amount of court fees and

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costs $ that remain unpaid; or

2) the date the inmate is released.

Accordingly and pursuant to Chapter 14 of the Texas Civil Practices and Remedies Code,the petitions as filed are ordered dismissed without prejudice. It is hereby, ORDERED,ADJUDGED AND DECREED that the action of Plaintiff against Defendant be dismissed withoutprejudice.

SIGNED AND ENTERED on this the lb day of UtMo-QT 2014.

PRESIDING JUDGE

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INMATE CORRESPONDENCE REPLY

To: FILE DATE: 04/15/14

ALFRED LEE STONE # 599665 CAUSE NO. : 14-0076

ESTELLE UNIT COURT: 349tH264 FM 3478

HUNTSVILLE, TX 77320

Dear: MR. STONE

_ We will need a notarized copy of your Inmate Trust Fund or a court order to preparethe copies you requested at no charge to you.

_X_ The following documents have been filed in the above listed case. File-stampedcopies of the documents are enclosed.

* MOTION FOR NEW TRIAL* AFFIDAVIT

* PROOF OF SERVICE

Today, the transcript of your Petition for Writ of Habeas Corpus hasbeen forwarded to the Court of Criminal Appeals.

Enclosed you will find a set of questions the Judge has ordered you to answer.Please fill out the form and mail it back to us.

Other:

All further correspondence should indicate the above Cause number.

By: \&&i** Lilian, Deputy District ClerkHouston County

Po Box 1186Crockett, Texas 75835-1186

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