Address: 123 E. West Ave

County: Franklin

Phone:745-675-9087

DOB: 09/23/1990                 Age:25

Sex/Race: Blk

Birthplace: Sumter SC

U.S. Citizen: X Yes  ☐ No

Other:

SSN:231-76-8970

DL No.: 1014568

ID No.:

FBI No.: 237467865

BCI No.: 347856

Height:6’1              Weight: 170

Eyes: Green                  Hair: Brown

X RT  ☐ LT  Handed

ID Marks: X Yes  ☐ No

Functional Limitations: ☐ Yes  X No

Highest Grade Completed:

Military Veteran: ☐ Yes  X No

County: Bishopville

PDN:

Presiding Judge: The Honorable Judge Reece

Prosecutor:

Phone:

Defense Counsel:

Phone:

Investigating Officer: Amy Ng

Referred: 27 March 2006

Follow Up: 24 April 2006

Completed: 25 April 2006

Typed:

Pretrial Supervision: X Yes  ☐ No

Pretrial Officer/Phone: Officer Knockville

Active Probation/Community Control: ☐ Yes  X No

Officer/Phone:

Active Parole/Post Release Control: ☐ Yes  ☐ No

Officer/Phone:

Detainers/Charges Pending:       Yes  X No

Disposition/Date:  /  01/17/2016

ORC No.:

Statutory Penalty:

Bond Amt. /Type:

Total Jail Credit:

Co-Offender (s): ☐ Yes  ☐ No

(If yes, list name (s) and docket number (s):

1. Name:                   / Docket Number:

2. Name:                   / Docket Number:

3. Name:                   / Docket Number:

ORC No.:

Statutory Penalty:

Bond Amt. /Type:

Total Jail Credit:

Co-Offender (s): ☐ Yes  ☐ No

(If yes, list name (s) and docket number (s):

1. Name:                   / Docket Number:

2. Name:                   / Docket Number:

3. Name:                   / Docket Number:

ORC No.:

Statutory Penalty:

Bond Amt. /Type:

Total Jail Credit:

Co-Offender (s): ☐ Yes  ☐ No

(If yes, list name (s) and docket number (s):

1. Name:                   / Docket Number:

2. Name:                   / Docket Number:

3. Name:                   / Docket Number:

ORC No.:

Statutory Penalty:

Bond Amt. /Type:

Total Jail Credit:

Co-Offender (s): ☐ Yes  ☐ No

(If yes, list name (s) and docket number (s):

1. Name:                   / Docket Number:

2. Name:                   / Docket Number:

3. Name:                   / Docket Number:

Supervision Adjustment (Adults):

☐ Single ☐ Married ☐ Divorced ☐ Separated ☐ Widowed

Current Marital Status: ☐ Single ☐ Married ☐ Divorced ☐ Separated ☐ Widowed

Number Of Marriages:        Current Marital Relationship: ☐ Good ☐ Fair ☐ Poor

Spouse:         Age:     Address:    Occupation:

Children:

If Yes, How Many Children Is The Offender The Biological/Custodial Parent: 2

Address:

Phone:

Comments:

History Of Criminal Activity Involving Co-Offender (s)/Accomplices: ☐ Yes  ☐ No

Organizations/Social Groups: ☐ Yes  ☐ No

Gang/Security Threat Groups Affiliations: ☐ Yes  ☐ No

If yes, list gang/rank:

Comments:

☐ Alone ☐ With parent (s) ☐ With children ☐ With spouse/domestic partner

☐ Grandparent (s)

Other (please indicate):

Current Living Arrangement:

☐ Alone ☐ With parent (s) ☐ With children ☐ With spouse/domestic partner

☐ Grandparent (s)

Other (please indicate):

Current Residence: ☐ House ☐ Trailer ☐ Apartment ☐ Room townhouse/condo

Other (please indicate):

Lives With (Names):

Cost: ☐ Owns/Mortgage ☐ Rents ☐ No Cost ☐ Subsidizes

Amount Offender Pays Per Month:

Length Of Time At Current Address:

Number of Addresses During Past Two Years:

Non-U.S. Citizens – Residence status:

INS Notified: ☐ Yes  ☐ No   Deportable: ☐ Yes  ☐ No

Comments:

Reason For Leaving:

Last School Attended:

Location:

GED: ☐ Yes  ☐ No  Year:

Difficulty Reading/Writing/Comprehending: ☐ Yes  ☐ No

Certifications/Special Training: ☐ Yes  ☐ No

If yes, list:

Comments:

Nature of Disability:

Presently Under Doctor’s Care:

Medical Condition (s):

Doctor/Phone:

Current Status: ☐ No Medical Provider Assigned  ☐ Current Medical Provider Assigned  ☐ Seeking New Medical Provider

Nature Of MH Issues:

In Counseling Currently:

Therapist/Phone:

Childhood Abuse: ☐ Yes  ☐ No

Suicide Attempts: ☐ Yes  ☐ No

MH Hospitalizations: ☒ Yes  ☐ No

When & Where: 1991-1992

Hospital: Unknown

Diagnosis: Depression

Past Social Service Involvement: ☐ Yes  ☒ No

When & Where:

PSYCH. Medication: ☐ Yes  ☐ No

Comments:

Current Status: Stable

Drugs Currently Being Used: None

Amount/Frequency:

Drug Treatment:

Where and When:

Was Treatment Completed: ☐ Yes  ☐ No

Current Status: Stable

Age Of First Alcohol Use:

Alcohol Currently Being Used:

Alcohol Treatment:

Where and When:

Was Treatment Completed:

Comments:

Primary Source Of Income:

Total Monthly Expenses:

Restitution Requested By Victims:

Total Amount Requested:

Comments:

Current Status:

Reason For Not Working:

Current Employer/Phone:

Job Title: Manager

Start Date:                      Supervisor:

Hours Worked Per Week:

Comments:

Comments:

 
Amy Ng

Approved By:

 
John Doe

cc: Judge (original)

Defense Counsel (1)

Prosecutor (1)

File (2)