Module 09: Returned Escapee No New Term
First Name (replace)
Last Name (replace)
NYS ID# * (replace)
DIN # (optional)
Prior Parole Eligibility Date*
Date Escaped*
Date Returned*
Prior Maximum Expiration Date*
Jail Time (New) (in days)*
Prior Term Max Sentence
yrs
mts
Parole Eligibility Date
Maximum Expiration Date
Conditional Release Date
X
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Sun
Mon
Tue
Wed
Thu
Fri
Sat