Carl Johnson - Bureau of Prison Forms

16 January 1999
Source: Hardcopy from Carl Johnson, Federal Correctional Institution - Tucson, AZ

Carl Johnson is currently at Federal Correctional Institution - Seatac, WA, awaiting trial before Judge Bryan, US District Court of Western Washington, Tacoma, WA. Federal Case No. CR-98-5393. No date has been set for trial.

See related files: http://jya.com/cejfiles.htm

James Bell is also at FCI - Seatac. See: http://jya.com/jdbfiles.htm

See related Kevin Mitnick site: http://www.kevinmitnick.com

[Form]

U.S. DEPARTMENT OF JUSTICE ACKNOWLEDGEMENTS OF INMATE

Federal Bureau of Prisons

_________________________________________________________________________

This form is to be completed by each inmate upon initial entry into the custody of the BOP. Staff shall also complete and sign as appropriate. The form is then re-completed only when the inmate desires a change in any section.

Inmate's Name
Johnson, Carl
Register No.
05987-196
Institution
TCN[Tucson?]

1. CORRESPONDENCE

The staff of each institution of the Bureau of Prisons has the authority to open all mail addressed to you before it is delivered to you. "Special Mail" (mail from the President and Vice President of the U.S., Attorneys, Members of the U.S. Congress, Embassies and Consulates, the U.S. Department of Justice (excluding the Bureau of Prisons but including U.S. Attorneys), other Federal law enforcement officers, State Attorney General, Prosecuting Attorneys, Governors, U.S. Courts, (including U.S. Probation Officers and State Courts) may be opened only in your presence to be checked for contraband. This procedure occurs only if the sender adequately identifies himself or herself on the envelope and the front of the envelope is marked "Special Mail--Open only in the presence of the inmate." Other mail may be opened and read by the staff.

If you do not want your general correspondence opened and read, the Bureau will return it to the Postal Service. This means that you will not receive such mail. You may choose whether you want your general correspondence delivered to you subject to the above conditions, or returned to the Postal Service. Whatever your choice, special mail will be delivered to you, after it is opened in your presence and checked for contraband. You can make your choice by signing Part I or Part 11.

Part I--General Correspondence to be Returned to the Postal Service

I have read or had read to me the foregoing notice regarding mail. I do not want my general correspondence opened and read. I REQUEST THAT THE BUREAU OF PRISONS RETURN MY GENERAL CORRESPONDENCE TO THE POSTAL SERVICE. I understand that special mail will be delivered to me, after it is opened in my presence and checked for contraband.

Signature of Inmate Register No. Date

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Part II--General Correspondence to be Opened, Read and Delivered

I have read or had read to me the foregoing notice regarding mail. I WISH TO RECEIVE MY GENERAL CORRESPONDENCE. I understand that the Bureau of Prisons may open and read my general correspondence if I choose to receive same. I also understand that special mail will be delivered to me, after it is opened in my presence and checked for contraband.

Signature of Inmate CJ Parker Register No. 05987-196 Date 12-2-98

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Inmate refused to sign this form. He (she) was advised by me that the Bureau of Prisons retains the authority to open and read all general correspondence. The inmate was also advised that his (her) refusal to sign this form will be interpreted as an indication that he (she) wishes to receive general correspondence subject to the conditions in Part 11 above.

Printed Name/Signature of Staff Member Date

2. AUTHORIZATION FOR DISPOSITION OF FUNDS

While confined within a prison facility under custody of the U.S. Attorney General or the Attorney General's designee(s), an inmate is prohibited from directly receiving or possessing (unless specifically authorized by the local institution) U.S. currency or checks, or other forms of negotiable instruments. To account for funds received on behalf of the inmate, the Bureau of Prisons establishes for each inmate a Prisoner's Trust Fund Account. The Director, Bureau of Prisons, or the Director's authorized designee(s) serves as the custodian of any and all funds received by an inmate while the inmate is incarcerated in the custody of the U.S. Attorney General.

I hereby (authorize) (~~do not authorize~~) [cross out one] the Director, Bureau of Prisons, or the Director's authorized designee(s), and the Warden or the Warden's authorized designee(s) in this or in any other federal institution in which I may later be confined, to sign my name as endorsement on all checks, money orders, or bank drafts, or other forms of negotiable instruments, for deposit to my credit in the Prisoner's Trust Fund Account, as long as I am a prisoner in the Bureau of Prisons. I understand that by not providing this authorization, I will not be able to receive checks, money orders, or bank drafts, or other forms of negotiable instruments while confined.

I further understand that all negotiable instruments sent to me should reference my name and register number in order to provide for proper deposit to my account. If my name and register number are not referenced, the institution mail room officer may return the negotiable instrument to the sender.

Signature of Inmate X CJ Parker Register No. 05987-196 Date 12-2-98

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Inmate refused to sign this form. He (she) was advised by me that his (her) refusal to sign this form will be interpreted as an indication that he (she) does not authorize the Bureau of Prisons to endorse on his (her) behalf all checks, money orders, or bank drafts, or other forms of negotiable instruments for deposit to his (her) credit in the Prisoner's Trust Fund Account and that he (she) will not be able to receive such funds while confined.

Printed Name/Signature of Staff Member Date

Distribution: Original--Central File
Copy-Inmate

BP-407(58)
USP LVN Previous editions not usable OCTOBER 1988

U.S. Department of Justice Acknowledgement of Inmate

Federal Bureau of Prisons (Continuation Sheet)

_________________________________________________________________________

3. MONITORING OF INMATE TELEPHONE CALLS

The Bureau of Prisons reserves the authority to monitor (this includes recording) conversations on any telephone located within its institutions, said monitoring to be done to preserve the security and orderly management of the institution and to protect the public. An inmate's use of institutional telephones constitutes consent to this monitoring. A properly placed phone call to an attorney is not monitored. You must contact your unit team to request an unmonitored attorney call.

I ~~have read~~ or had read to me (cross out one) the above notification on the monitoring of inmate telephone calls. I understand that telephone calls I make from institution telephones may be monitored and recorded.

Signature of Inmate X CJ Parker Date 12-2-98

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I hereby certify that the above information was [cross out incorrect statements] (~~provided to the inmate to read~~) and/or was (read and fully explained by me to the above inmate). The inmate (signed)/(~~refused~~) to sign.

Printed Name/Signature of Staff Member P Sheehy Date 12-2-98

4. NOTIFICATION IN CASE OF DEATH/ILLNESS, DISPOSITION OF PROPERTY

In the event I should die, I direct that my Sister (relationship),

whose name is XXXX XXXXXXX

and whose address is XXXXXXX XX

XXX XXX XXXX (Telephone Number) be notified. [Xs by JYA.]

In the event the Bureau of Prisons staff is unable to locate the above designated person, following a reasonable search, I authorize the substitution of the following person in his or her stead .

(Name) (Relationship)

(Address) __________ (Telephone Number) __________

I authorize the Bureau of Prisons to transmit my property and personal effects including money remaining to my credit in, or due me from the Bureau of Prisons to my next of kin in accordance with state law.

I agree further that disposition may be made of my personal property located within the prison facility, including clothing, in accordance with the rules and regulations of the Bureau of Prisons.

In case of serious illness or other emergency the above named persons may be contacted to be notified of my condition I also desire and authorize that the following be notified.

NAME RELATIONSHIP ADDRESS TELEPHONE NO.

_______________________________________________________________________

Signature of Inmate X CJ Parker Date 12-2-98

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I hereby certify that the above notification was [cross out incorrect statements] (~~provided to the inmate to read~~) and/or was (read and fully explained by me to the above named inmate) before the inmate (voluntarily signed)/(~~refused to sign~~) this notification, this 2 day of Dec , 19 98 .

Printed Name/Signature of Staff Member P Sheehy Date 12-2-98

Distribution: Original--Central File
Pink Copy--Inmate

BP-408(58)
USP LVN Previous editions not usable AUGUST 1991

[End Acknowledgements of Inmate forms]

[Form]

U.S. DEPARTMENT OF JUSTICE INMATE REQUEST TO STAFF MEMBER

Federal Bureau of Prisons

_______________________________________________________________________

DATE Thurs, Jan 7/99

TO: Warden Hood
(Name and title of officer)

SUBJECT: State completely but briefly the problem on which you desire assistance, and what you think should be done (Give details).

[Handwritten] Due to the continuing inability of BOP Medical Staff to adequately treat my medical disability, I will be unable to get out of The Hole (TM) in order to obtain Commissary and repay the kindness of Yucca South Inmates who provided me with material items & support that allowed me one wonderful week of respite, in my five months of incarceration from being Locked Down like an Animal for a minor disability.

(Use other side of page if more space is needed)

NAME: Carl Johnson No. 05987-196

Work assignment: ________________________________________ Unit: _________

_______________________________________________________________________

NOTE: If you follow instructions in preparing your request, it can be disposed of more promptly and intelligently. You will be interviewed. if necessary, in order to satisfactorily handle your request. Your failure to specifically state your problem may result in no action being taken.

_______________________________________________________________________

DISPOSITION: (Do not write in this space) DATE ______________

_________________________
Officer

Original - File
Canary - Inmate

BP-148(55)
USP LVN Previous editions not usable OCTOBER 1986

[End request form]

[Form]

U.S. DEPARTMENT OF JUSTICE INMATE REQUEST TO STAFF MEMBER

Federal Bureau of Prisons

_______________________________________________________________________

DATE Thurs, Jan 7/99

TO: Ms. Denise Derouen / Staff Psychologist
(Name and title of officer)

SUBJECT: State completely but briefly the problem on which you desire assistance, and what you think should be done (Give details).

[Handwritten] Due to being in LockDown for medical deficiencies in the BOP I am unable to talk via phone to my family, after the recent loss of my Stepmother. I would like to have the SHU Phone Punishment Rules lifted, if possible.

(Use other side of page if more space is needed)

NAME: Carl Johnson No. 05987-196

Work assignment: ________________________________________ Unit: SHU

_______________________________________________________________________

DISPOSITION: (Do not write in this space) DATE ______________

_________________________
Officer

Original - File
Canary - Inmate

BP-148(55)
USP LVN Previous editions not usable OCTOBER 1986

[End request form]