Executions

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4/20 EXAMPLES

Text in this Example:

EXECUTIONS
NAME OF DECEDENT:
This form is to be completed in addition to the ROD form in these guidelines
DATE EXECUTION SCHEDULED:
TIME:
PLACE:
MANNER OF EXECUTION
IF BY LETHAL INJECTION, IDENTIFY DRUG(S) INVOLVED, QUANTITIES AND INTERVALS OF
INJECTIONS IF MORE THAN ONE:
COMPLICATIONS, IF ANY:
OMI ASSUMED CUSTODY OF REMAINS AT: DATE:
STAFF REPORT OF RECORD REQUEST ED: DATE:
COPY OF EXECUTION RECORD REQUEST ED: DATE:
COPY OF DECEDENT'S MEDICAL AND PRISON RECORDS REQUESTED: DATE:
BODY TAGGED AND SEALED BY:
DATE:
BODY TRANSPORTED SEALED WITH SEALED RECORDS BY:
TO OMI ALBUQUERQUE.
NAME OF INVESTIGATOR
DMI#