SOP_NUMBER: 209.09-att-7
TITLE: Tier III Program 90-Day Review_Classification Appeal Form
REFERENCE_CODE: IIB09-0004
WORD_COUNT: 352
URL: https://gps.press/sop-data/209.09-att-7/

ATTACHMENTS:
  1. Tier III Program Assignment Request Form
     URL: https://gps.press/sop-data/209.09-att-1/
  2. Special Management Unit: Tier III Program Assignment Memo
     URL: https://gps.press/sop-data/209.09-att-2/
  4. Special Management Unit: Tier III Program 90-Day Review Hearing Form
     URL: https://gps.press/sop-data/209.09-att-4/
  5. Special Management Unit: Tier III Program 60-Day Review Hearing Form
     URL: https://gps.press/sop-data/209.09-att-5/
  6. Special Management Unit: Tier III Program Privileges Chart
     URL: https://gps.press/sop-data/209.09-att-6/
  7. Tier III Program 90-Day Review_Classification Appeal Form
     URL: https://gps.press/sop-data/209.09-att-7/
  8. Tier III Program 60 Day Review_Classification Appeal Form
     URL: https://gps.press/sop-data/209.09-att-8/
  9. Special Management Unit: Tier III Program Cell Check Sheet
     URL: https://gps.press/sop-data/209.09-att-9/
  10. Tier III Program Checklist
     URL: https://gps.press/sop-data/209.09-att-10/
  11. Special Management Unit: Tier III Program Offender Management Plan
     URL: https://gps.press/sop-data/209.09-att-11/
  12. Tier III Program Over 2-Years 90-Day Quarterly Review Hearing Form
     URL: https://gps.press/sop-data/209.09-att-12/

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FULL TEXT:
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SOP 209.09
Attachment 7

04/23/25
Page 1 of 2

**Special Management Unit: Tier III Program**

**90-Day Review/Classification Appeal Form**

**I.** **Offender: _________________________ GDC #: __________________**

**Phase: __________ Bed Assignment__________ Date _____________**

**II.** **Appeal of Special Management Unit: Tier III Program Classification Committee Action**


I wish to appeal the decision of the Special Management Unit: Tier III Program Classification Committee
regarding my 90-Day Review:

**REASON** **FOR** **APPEAL (within 5 Business Days from date Notice of 90-Day Review Hearing Form**
**(Attachment 4) submit to the assigned counselor who shall forward to the SMU Warden (or designee)).**

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

______________________________ _________________
**Offender’s Signature** **Date**

**Date appeal received: ______________ By: _____________________________(COUNSELOR)**

**Offender Acknowledgment Appeal Received by Counselor: _____________________________**
_**Signature/Date**_
**Date Appeal Sent to SMU Warden (or designee): ______________** _**(Send within 3 calendar days of receipt of**_

_**Appeal)**_

_****If appeal is for denial of transfer to Tier III STEP, send directly to Director, Field Operations (or designee)****_

**Date Appeal Sent to Director, Field Operations (or designee): __________________** _**(send within 3 calendar**_
_**days of receipt of Appeal)**_

**III.** **SMU Warden (or designee) Review**


**Date Appeal Received: ____________**

**I** **concur /** **disagree** with the Special Management Unit: Tier III Program Classification Committee's
Action and the following recommendation(s) has/have been made in this case:


________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

**_______________________________** **_________________**
**SMU Warden (or designee)** **Date**

**Date Appeal Sent to Director, Field Operations (or designee): ____________________**
_**(Send within 10 business days of receipt of Appeal)**_


Retention Schedule: Upon completion, this form shall be placed in the offender’s institutional file.


SOP 209.09
Attachment 7

04/23/25
Page 2 of 2


**IV.** **Director, Field Operations (or designee) review**


**Date Appeal Received: ________________**

**I** **concur /** **disagree** with the Special Management Unit: Tier III Program Classification Committee's
Action and the following recommendation(s) has/have been made in this case:


_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

__________________________________ __________________
**Director, Field Operations (or designee)** **Date**

**Date Appeal Sent to Assistant Commissioner for Facilities: ____________________**
_**(Send within 10 business days of receipt of Appeal)**_

**V.** **Assistant Commissioner for Facilities**


**Date Appeal Received: ________________**

**I** **concur /** **disagree** with the Special Management Unit: Tier III Program Classification Committee's
Action and the following decision(s) has/have been made in this case:


_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

_________________________________________      ____________________
**Assistant Commissioner for Facilities** **DATE**

**VI. Offender’s Acknowledgment of Final 90-Day Review Appeal Decision**


**_______________________________________________**
_**Signature/Date**_


Retention Schedule: Upon completion, this form shall be placed in the offender’s institutional file.