I-162 Form Attorney/Inmate Telephone Call Application

ATC-100 (Rev. 5)

Attachment 1

TEXAS DEPARTMENT OF CRIMINAL JUSTICE

Attorney, Consul, or Designated Representative/Inmate Telephone Call Application

ATTORNEY/CONSUL INSTRUCTIONS

?

?

?

?

?

Complete Section I. a or b and c (for designated representative).

Complete Section II, except for information fields marked with an asterisk (*).

Section I. a or b and c (for designated representative) will need to be complete and accurate.

Contact Access to Courts staff at the inmate¡¯s unit of assignment for the appropriate email address and forward

completed form. Include with email a legible copy of your State bar card/United States Department of State

Identification Card and driver license.

Confirm application approval and procedures with inmate¡¯s unit of assignment the business day prior to the requested

telephone call.

NOTE: Eligible inmates shall be permitted to place calls to their attorney(s) of record, using the Inmate Telephone System (OTS), once the

attorney has successfully registered, in accordance with ED-03.32.

If you have any questions regarding the completion of this form, please contact Access to Courts staff at the inmate¡¯s unit of assignment.

I. ATTORNEY/CONSUL/DESIGNATED REPRESENTATIVE INFORMATION

a) Attorney information:

Name:

State Bar No.:

.

Address:

Telephone No.:

.

Email address:

.

(This number must be listed with the State bar association)

Attorney Affirmation: I have an existing

attorney-client or ____attorney-witness relationship with the inmate identified in this

application. I understand that the confidential telephone call, for which I am applying, may not be used to accomplish any non-attorneyclient or non-attorney-witness communication. In order to facilitate this telephone call application, the telephone number

provided must be verified via the State Bar as it will be the number utilized for the call.

Attorney Signature:

Date: _______________________________

b) Consul information:

Name:

PID No.:

.

Address:

Telephone No.:

.

Email address:

.

(This number must be verifiable through the U.S. Department of State, Office of Protocol)

Consul Affirmation: I affirm that the confidential telephone call with this inmate is to provide consular services to a foreign national

from my country and for no other purpose. In order to facilitate this telephone call application, the telephone number provided

must be verified via the U.S Department of State, Office of Protocol.

Consul Signature:

Date: ________________________________

c) Designated Representative information:

Name: _____________________________________________________

Address: _________________________________________________________________________________________

Telephone No.:

Email address:

.

(This number must be listed on the I-164 ¡°Application to Call/Visit TDCJ Inmate as Designated Representative¡±)

Attorney Affirmation: I understand that the confidential telephone call, for which I am applying, may not be used to accomplish any

non-attorney-client or non-attorney-witness communication.

Attorney Signature:

Date: _______________________________

Consul Affirmation: I affirm that the confidential telephone call with this inmate is to provide consular services to a foreign national

from my country and for no other purpose.

Consul Signature:

Date: ________________________________

I-162

(rev. 05/2024)

ATC-100 (Rev. 5)

Attachment 1

II. INMATE IDENTIFICATION

Name:

TDCJ #:

*Custody Status:

*Housing Location:

Requested Date and Time of Telephone Call:

*Unit:

.

*Job Assignment:

.

.

III. TDCJ UNIT INFORMATION

(Official Use Only)

Approved Date and Time of Telephone Call:

.

Method used to verify attorney¡¯s, consul¡¯s or designated representative¡¯s identity:

¡õ State Bar via phone ¨C State:

¡õ State Bar Online ¨C State: ______

¡õ U.S. Department of State, Office of Protocol via phone

¡õ Other: ______________________

Copy of Bar Card Attached: Yes ¡õ No ¡õ

Copy of Driver License Attached: Yes ¡õ

Copy of U.S. Department of State Identification Card Attached: Yes ¡õ No ¡õ

No ¡õ

Authorization for an attorney, consul, or designated representative/inmate telephone call will be made by the unit Access to Courts

Supervisor or designee.

AUTHORIZED:

Yes ¡õ

No ¡õ

Date:

Signature:

.

Printed Name:

.

Reason not authorized:

.

Approval for an attorney, consul or designated representative/inmate telephone call must be made by the warden, assistant warden, or

designee, to ensure compliance with BP-03.81.

UNIT APPROVED:

Yes ¡õ

No ¡õ

Date:

Warden¡¯s Signature:

Reason not approved:

Was call completed? Yes ¡õ No ¡õ

.

Printed Name:

.

.

Date:

Start time:

AM/PM End Time:

AM/PM

If call was not completed, why?

ATC Staff Signature:

.

Printed Name:

.

cc: Inmate¡¯s Unit File

Unit Access to Courts Supervisor

I-162

5/2024

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download