form is to be used only as all Out-Count. No other form will be accepted in lieu of the Out-Count Form. EFTA00119799 g— Unit: Metropolitan Co 'onal Center Official Cou s Slip Unit: Date Count: Count. lime: Print Name: Print Name: Signature: Signature: Print Name: Print Name: Signature Sign

AFFORD MURPHY BANKS JONES LEWIS B-A C-A E-N E-S H-A I-N K-N 1 IC-S _ Total Out-Counted: 5 P F [ENT OF JUSTICE )F PRISONS JNT FORM onal Center Fit 10007 Count Time: 4:00 pm Location: FNYS QTR E06-545L G01-702L G11-783U G11-786U K04-129U N G-S 2 Z-A Z-B This Form must be submit