Module 12: Returned Escapee with Consecutive New Term

First Name (replace)
Last Name (replace)
NYS ID# * (replace)
DIN # (optional)
Prior Parole Eligibility Date*
Date Escaped*
Date Received at DOCCS on New Term*
Prior Maximum Expiration Date*
New Minimum Term* yrs mts
New Maximum Term* yrs mts
Jail Time (New) (in days)*
Prior Term Max Sentence yrs mts

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