EFTA00181807.pdf

09/21/09 OFFENDER COP OBLIGATIONS TIME: 16:34:23 OPSB003-XX CHANGE ORDER PAGE: 1 OFFICER NUMBER: 07824 OFFICER NAME: SLOANE, CARMEN DOC NO: NAME: EPSTEIN, JEFFREY STATUS: ACTIVE P/P ACCT CASE PAYEE ACCT ORIGINAL PAYMENT CURRENT FINAL PFX SEQ CO NUMBER ID NUMBER TYPE COP OBLIG. SUR SCHEDULE BALANCE PYMNT DUE 01 001 50 0809381 1000UNT050 03 C 473.00 Y 0.00 0.00 03/23/10 01 001 50 0809381 33DCDRG000 09 65.00 Y 10.00 65.00 03/23/10 `-1►C. 01 001 50 0809381 33DCTRN001 24 C 24.00 Y 0.00 0.00 07/21/10 01 001 36STPLA001 11 0 600.00 Y 54.55 485.54 07/21/10 OFFICER: DATE: SUPERVISOR: DATE: CJIT: DATE: EFTA00181807  FLORIDA DEPARTMENT OF CORRECTIONS TIME: 15:23:16 AS OP: 08/07/09 COURT ORDERED PAYMENTS PAGE: OFFICE: LAKE WORTH OFFENDER FINANCIAL OBLIGATION AGREEMENT OPS0112-02 VERIFICATION DOCUMENT OFFICER: SLOANE, CARMEN OFFENDER: EPSTEIN, JEFFREY DOC NO:IIIIIIIUPERVISION BEGIN DATE: 07/22/09 SCHED TERM DATE: 07/21/10 PAYEE: DEPARTMENT OF CORRECTIONS DRUG TESTING FINAL PAYMENT DUE DATE: PAYEE ID: 33DCDRG000 03/23/10 t PAID Ot ORIGINAL AMOUNT OWED: $65.00 t SUPERVISION REMAINING: PREFIX: 01 NET CHANGE: 92t ACCT SEQ: $0.00DB PAYMENT SCHEDULE: $10.00 TOTAL OBLIGATION: $65.00DB AVERAGE PAYMENT CASE NO: UNIF CS#: PAID TO DATE: $0.00 STATUS: USPENDED $0.00 LAST PAYMENT DATE: 00/00/00 BALANCE $65.OODB SURCHARGE Y PAYEE: DC OFFICER TRAINING/EQUIPMENT SURCHARGE FINAL PAYMENT DUE DATE: PAYEE ID: 33DCTRN001 07/21/10 % PAID 0% ORIGINAL AMOUNT OWED: $24.00 t SUPERVISION REMAINING: PREFIX: 01 NET CHANGE: 92% T SEQ: 001 $0.00DB PAYMENT SCHEDULE: $10.00 ' TOTAL OBLIGATION: SE NO: 0809381 524.OODB AVERAGE PAYMENT $0.00 UNIF CS#: PAID TO DATE: $0.00 ATUS: DEFERRED LAST PAYMENT DATE: 00/00/00 BALANCE $24.0008 SURCHARGE Y PAYEE: STATE OF FLORIDA COST OF SUPERVISION FINAL PAYMENT DUE DATE: PAYEE ID: 36STPLA001 07/21/10 t PAID Ot ORIGINAL AMOUNT OWED: $600.00 t SUPERVISION REMAINING: PREFIX: 01 NET CHANGE: 92% ACCT SEQ: 001 $0.00DB PAYMENT SCHEDULE: $54.55 TOTAL OBLIGATION: $600.00DB AVERAGE PAYMENT CASE NO: UNIF CS#: PAID TO DATE: $0.00 STATUS: OPEN $0.00 LAST PAYMENT DATE: 00/00/00 BALANCE $600.OODB SURCHARGE Y RECAP ORIGINAL OBLIGATIONS: $689.00 TOTAL SURCHARGE: $27.56 ALL COPS PAYMENTS ARE TO BE MADE PAYABLE TO THE DEPARTMEN TOTAL NET CHANGE: $0.00DB T OF CORRECTIONS (DC), AND ARE TO BE IN GUARANTEED FORM OF PAYMENT SUCH TOTAL PAYMENTS: $0.00 AS A MONEY ORDER OR CASHIER'S CHECK. VISA AND MASTERCARD MAY BE ACCEPTED. TOTAL BALANCE: $716.56DB SURCHARGE DUE: $2.98 PAYMENTS DUE: $74.55 REQUIRED PAYMENT: ...RIPIBD BY OFFICER:a czig____ $77.53 DATE: I UNDERSTAND MY SPECIAL CONDITION(S) TO FULFILL THIS c--1 I-o 9 FINANCIAL OBLIGATIONS) PRIOR TO MY SCHEDULED SUPERVISION TERMINATION DATE(S) AS ORDERED BY THE SENTENCING AUTHORITY, AND ACKNOWLED GE RECEIPT OF A COPY OF THIS FINANC OBLIGATION AGREEMENT. FAILURE TO COULD RESUL OLATION OF SUPERVISION. OFFENDER( DATE: I r EFTA00181808 07/24/09 OFFENDER COP OBLIGATIONS TIME: 08:35:52 0PSB003-XX CHANGE ORDER PAGE: 1 OFFICER NUMBER: 07824 OFFICER NAME: SLOANE, CARMEN DOC NO: NAME: EPSTEIN, JEFFREY STATUS: ACTIVE P/P ACCT CASE PAYEE ACCT ORIGINAL PAYMENT CURRENT FINAL PFX SEQ CO NUMBER ID NUMBER TYPE COP OBLIG. SUR SCHEDULE BALANCE PYMNT DUE 01 001 50 0809381 10C0UNT050 03 S 473.00 Y 59.13 473.00 03/23/10 01 002 50 0809381 10COUNT050 03 S 473.00 Y 59.13 473.00 03/23/10 01 001 50 0809381 33DCDRG000 09 S 65.00 Y 10.00 65.00 03/23/10 01 001 50 0809381 33DCTRN001 24 D 24.00 Y 10.00 24.00 07/21/10 01 001 36STFLA001 11 O 600.00 Y 50.00 600.00 07/21/10 D_ekfc.tc QA/N.,A-tnca --e-trtry („oit-A OFFICER: aa DATE: 2(-1-oq SUPERVISOR: DATE: CJIT: DATE: EFTA00181809 r0 Hirer ; 15-4 Court-Ordered Paym ent System 4, bate (n-so-lzg INPUT FORM *Offendiiiiiii 1/43 -2.1- FOR OP021 INITIAL EN *DC # TRY OF PAYEE PAYEE PAYEE NAME* TYPE PAYEE ADDRESS* CODE CONTACT PAYEE PERSON/ OFFCR SUPv DATA EN/ IF .INIT PHONE INIT ENTRY KNOWN NUMBER INITIAL 33 bru,q cstil DATE Trai A s 5- Tr10% r-rysl C-A c7 10 P,s, ti-i, derK 3tscrttAoo Ger 10 0 O 10 psy . .CIerK I0to vavvo5 Git a r.s. Qty. cltrY... CP D. Fee) ICt o &nT05 e FOR OM ;,5-CcranTX 0 PFX* - OR -:OP04 1 OR 2 INI EQ* CNTY CASE# TIAL ENTRY OF PAYEE ACCOUNT ACCT ORIGINAL CODE MONTHLY FIN AL TYPE* OBLIGATION PAYMEN CLAIM POLICY S/DM/PAYEE T PAY DUE ATTENTION 03 SCHEDULE ACCOUNT? DATE (25 , a l-1, L-113 01,7-A tile) vonithroi FOR OP22 2 INITIAL ENTR CP *7 ee_ S 500 Y OF SUPERVISION FEE MO r RATE NTHLY RATE F DATE / / . COS - P lizo,Asz em -}¢r O n CSO OR OFCR WIT/ SUPV INIT/ ADM[ 1 INIT RATE DATA ENTRY Supv Length End Date r RATE Reason DATE _J INIT. J_ DATE _/____/._ DATE __/_ F DATE _j_f ___/___ EM 1 OFCR mart INIT RATE OR SUPV EMIT/ DATA ENTRY , Supv Length End Date DATE ....f J_ Reason INIT. FOR OP24 2 INITIAL ENTR DATE _J__J___ DA IRATE Y OF PRC SUBSISTENCE TE _J---i— RATE $6.00 PRC Lengthy-364 Days-OR DAILY RATE F DATE _J I t $0.00 END DATE / OFCR 'NIT/ / SUPV INIT/ DATA ENTRY Reason IN' DATE __!_I_ DATE ___/__ 1 DA'A e I / EFTA00181810  ,PFICE R DATE -1 o COURT- ORDER 2-%-t f Dcg ED CHANGEPAYMENT SYSTEM Override FORM Paymen tU OPOS 4 (S ndisbureedfinte enior Cle rk) mal Ca-) OFFEN DER S Chan DOC # Sentenc ge Original Oblig Pete. Payne ing Auth POO / ority•Ord ation CA) OPOS 1 SW (Lead Cle orodICOS Prepa amid piw pwia.0•m• elLitt, cm,/l) Comemot $ rica y EM Rate Cha OP22 2 (C nge Cods vas 0.e 1D C-0 vm 4 - 4 n 4. Ia56 AT) Transfe yin Ak Sat1 r Payme a Maws Vita nt from O Milealke OI O Payee to ne DC#I Newfa S (COPS A Another ma V* Deveam t$ Obilerde e$ ccountin TO —t i e •OJ Nurnbte W Mats Awa g) Seq. Mawis it et Amon COS Wa .21. MMat Centinea $ co $ l Cod. Reosipt altos A DOT Officor en Cede (009 mount fad 061.44 Fonstic e .R Now Roo / I PROS: O Pagel/ POI 0C Tup•Mis of MO* lason Cods Sias C Oillow b TO: DOC lot W illa eta PoymD $4. -.1.t / cg) Mat W x Skis as Oita w floorvti eal CoonTia l Coot o r Sas Delete O 0111olv k OPOS 4 (S verride canto ale s enior Cle tan*/ rk) Mita Payntla Change COPS N nw to Oblig 7 ag Ma Correcti ation le OsetO on/Inpu OPOS 1(l t Error ead Cle COS Rate P as rical) Change Sep I Pas Na *aft m OP22 2 Coroson $ (CJIT) Rotund/O t Code Par's OS ve Ofloctive (COPS A rpayment to DC hoefO POI OM* cctg Ap Payee la OarRato $ proval R ON equest) hoot/ Nowa W NewRa Mona Olen tom la EOM tee un Cod s/ °Omer A MrountS Nara -0I- ddss: CommeraC Obijam [Mao e m et PowP S Soto Ad am* Ors Fonda .% SIAS Olitatirra POI DP ls Cona nCods Race C ods Iota *tram w as Orabied Arnowet I s Wier C Coore httata Surma« law a Cods sk OffiaprInst als trod Mea Suponis nt 1,41001 or kaiak Caw lad aS Ch e air No leolac " iet4 at vitae % Ca% AanlO nVaa• EFTA00181811  Sr Banner - (Custom Easy Wow Inquiry (CWICTYU 3.3.1) (..IISPROD)J Rend Widow Held $elirdibiTers, Desc EPSIE:pc, JEFFREY E a :J Case ID in. • I ••. AIR Sr-100 Cave Filed Citstrn NJrra Jea.R. CF FELONY Case two 'verily Ina/ Dates Waived r Court Type Ow .4 cm Demand Status CLSD CLOSED CASE Deadline 4-)Are2007 PA Lacs I /43atlgs/Events Sent/AFFIFFIF Charge Status AneStrnands I Related Cases Yon we rut rently in CASE SC ear n Rn EFTA00181812  ,Officer's Name: For Month Ending: STATE OF FLORIDA RTME NT OF CORRECTIONS Date/Time submitted: DEPA WRITTEN MONTHLY REPORT YO n EMPLOYER: fet e DC# SUPERVISOR'S NANIEVanfaVI-LaC-fe YOUR RESIDENCE ADDRESS: (include Name of EMPLOYER'S ADDRESS: Subdivision, Apartment Complex and Number. 2-t Stat PIN Mobile Home Park and Lot Number, ifapplicable): a it Wrat tails geocin i s 334d S 61 &Ito Way EMPLOYER'S TELEPHONE N alai a ga a (n F2- 32/4160 CELLULAR TELEPHONE No. - NOT Post Office Box) (Provide physical locatio PAGER No. EMPLOYER EMAIL: TELEPHONE No YOUR TOTAL MONEY EARNED MONTHLY: CELLULAR TELEPHONE N $ /0 K f- (Gross Amount) PAGER No. Full time Part-time Hours Worked Additional (2s ) emplo yment inform ation: Vehicle Make/Model/Year/Tag #: s who resided at your residence during this month: Llsjfull names, ages, and your relationship to all person R. -ah• — VC,- scroPoL42. EA &AC* 2:‘ 7 el n r4 Ur VI) srpp_ YES nave you consumed alcoholic beverages? 0 nces? Have you used or bought illegal drugs or controlled substa ed educa tional, vocati onal classes or menta l Have you attend ent progra ms? health, drug, alcohol, therapy, or self-improvem (If yes, circle which one) enforcement during the last month? Have you been arrested or had any contact with law , attached to report. If yes, explain what happened on separate sheet of paper If you went into debt for any reason, explain: If not working, give reason and source of income: Officer, explain: If you have any questions or problems to discuss with your : If monetary obligation owed, amount paid this month SUBMIT CASH OR PERSONAL CHECKS! Receipts are available through your probation officer. DO NOT Make money order payable to the Department of Correction reason and date when payment will be made: If monetary obligation owed and no payment made, give I certify the above to be true and complete- Signature of Officer Offic ei ve Your Signature: Mailing Address: Date WMR Received: City: Date WMR Due: 5-4 Zip: Comments: State: E-Mail Address: (if applicable) EFTA00181813  Officer's Name: STATE OF FLORIDA For Month Ending: DEPARTMENT OF CORRECTIONS I Date/Time submitted: WRITTEN MONTHLY REPORT YAWS EMPLOYER: SUPERVISOR'S NAME: —nib "1/'-'. YOUR RESIDENCE ADDRESS: (include Name of EMPLOYER'S ADDRESS: Subdivision, Apartment Complex and Number, Mobile Home Park and Lot Number, if applicable): -1•re - ILA » giai m etext, FtsgVosi EMPLOYER'S TELEPHONE N CELLULAR TELEPHONE No. (Provide physical location —NOT POSI Office Box) PAGER No. TELEPHONE No. EMPLOYER EMAIL: YOUR TOTAL MONEY EARNED MONTHLY: CELLULAR TELEPHONE No.altall $ wto tC (Gross Amount) PAGER No. Full time 4 1 Part-time Hours Worked Vehicle Make/Model/Year/Tag Additional (tad) employment information: List full names, ages, and your relationship to all persons who resided at your residence during this mak: 1 - 644 L • 1,1 - Plied - £ 4 -3-6 - %Cr Lc tt= - Pki YES lave you consumed alcoholic beverages? 0 Have you used or bought illegal drugs or controlled substances? 0 Have you attended educational, vocational classes or mental health, drug, alcohol, therapy, or self-improvement programs? 0 (If yes, circle which one) Have you been arrested or had any contact with law enforcement during the last month? ❑ 6 If yes, explain what happened on separate sheet of paper, attached to report. If you went into debt for any reason, explain: If not working, give reason and source of income: If you have any questions or problems to discuss with your Officer, explain: if monetary obligation owed, amount paid this month: Receipts are available through your probation officer. DO NOT SUBMIT CASH OR PERSONAL CHECKS! Make money order payable to the Department of Corrections. If monetary obligation owed and no payment made, give reason and date when payment will be made: Official Use Only: I certify the above to b. nd Signature of Officer Receiving Report: Your Signature: Mailingdtddress: CC - date WMR Received: Gti Date WMR Due: City: e2 , (17C4-A Comments: State: c (--• Zip: 3>'(t' E-Mail Address: 3 e..e(A9o-r Pc -t. it"A—• (if applicable) \ EFTA00181814  ifficer's Name: For Month Ending: STATE OF. FLORIDA Date/Time submitted: DEPARTMENT OF CORRECTIONS WRITICEI•1 MONTHLY REPORT YO -c-frEy Epstein EMPLOYER:F5F SUPERVISOR S NAME: --.5 1 4•1 I (Cr YO 8 "RA. Ill :4 1 r DRESS: (Include Name of EMPLOYER'S ADDRESS: Subdivision. Apartment Complex andNumber, M ile and Lot Number, if applicable): 250 5•AuSitutiaa fite.eAlevicf4 likoti-`itturn ?math trzZ34O1- - Ch F L EMPLOYER'S TELEPHONE Na CELLULAR TELEPHONE No PAGER No. TELEPHONE EMPLOYER EMAIL: YOUR TOTAL MONEY EARNED MONTHLY: CELLULAR $ (Gross Amount) PAGER No. Full tinsel_ Part-ti