SOP 206.01-att-2: Request/Authorization to Receive Books, Magazines, and Newspapers

SOP 206.01
Attachment 2
3/19/18

               _______________________

Facility Name

              ____________________

Address

________________________

City, State, Zip

R EQUEST/AUTHORIZATION TO RECEIVE BOOKS, MAGAZINES, and NEWSPAPERS

NAME `:` GDC# FACILITY `:` DORM `: ___`

Permission is being requested for the above-named offender to receive the following item(s): I certify that the item(s)
checked are for my personal use only and that I will not hold the facility responsible for loss, theft, or damage of said item(s).
I also understand that authorization to order does not oblige the facility to allow the item (s) if it fits the criteria for rejection
per SOP 227.06, Offender Receipt of Mail.

OFFENDERS'S SIGNATURE `: _______________________________`

|QTY
REQ|DESCRIPTION|QTY
APP|QTY
REC|QTY
REQ|DESCRIPTION|QTY
APP|QTY
REC|
|---|---|---|---|---|---|---|---|
|||||||||
|||||||||
|||||||||
|
||||||||

TO SENDER `:` The item(s) listed above are the only item(s) that may be sent directly from the Publisher. Any

item(s) other than those approved above shall be returned at the expense of the offender within
thirty (30) days or be destroyed.

The above item(s) are approved as indicated. This approved form must be maintained until the item(s) are received. Once the
item(s) are received they will still be reviewed for appropriate content. The item(s) must be received within thirty (30) days
of the date approved or they will be returned to sender.

DATE `:` APPROVED `:` DISAPPROVED `:` BY `: _________________________`

Warden or Designee
DATE RECEIVED `:` OFFENDER’S SIGNATURE `: __________________________`

DISTRIBUTION: (APPROVED) Original to offender's institutional file/Copy to Mail Room or Property
(DISAPPROVED) Original to offender's institutional file/Copy to offender

RETENTION SCHEDULE: Upon completion of this form, it shall be placed in the offender’s institutional file.