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LOCKER # <br />ShER\F <br />LANE COUNTY ADULT CORRECTIONAL FACILITY <br />The following is a list of items not allowed inside Lane County Adult Correctional Facility. The list is not all - <br />inclusive and some items may be at the discretion of the Booking Deputy. <br />Weapons (including knives), fireworks, matches, lighters, scissors, food items, razors. Additionally, anything too <br />large to fit into one property bag will not be accepted. . <br />I certify that I have inventoried and placed into bag # <br />the personal property belonging to: <br />L KID AZuj_ DO <br />NAME /DOB /AIRS# <br />I further certify that I have not included any of the items listed a <br />ARRESTING OFFICER SIGNATURE <br />BELT /BUCKLE <br />CELL - PHONE DKt k <br />CHECKBOOK <br />CIGARETTES <br />GLASSES W- O DAME <br />JEWELRY <br />KEYS <br />ODLAD 3 55 '7 5> <br />PURSE <br />TOILETRIES <br />WALLET I <br />WATCH —� <br />o / -/a /s'4 7 <br />BADGE #/ AGENCY/ DATE/ TIME <br />CITE # <br />CITE # <br />CITE # <br />MISC. f L L 0CK6f—' � <br />my, e6:m1CT16 <br />PAPER MONEY ° <br />THE ABOVE PROPERTY IS BEING HELD FOR ME BY THE LANE COUNTY ADULT CORRECTIONAL <br />FACILITY UNTIL MY RELEASE. I UNDERSTAND THAT ANY PROPERTY LEFT OVER 60 DAYS PAST <br />MY RELEASE, OR TRANSFER, WILL BE DISPOSED OF BY THE LANE COUNTY ADULT <br />CORRECTIONAL FA <br />INMATE SIGNATUf/ DATE <br />REFUSED /UNABLE <br />PROPERTY BEING RELEASED/ DATE/ TIME <br />C78 -43 White - Arresting Agency Goldenrod - Records Pink - Inmate <br />