CJ-10A Annual Summary on Inmates in Private and Multi-Jurisdict

OMB No. 1121-0249 Approval Expires 12/31/2012

CJ-10A

FORM
(10-5-2009)

U.S. DEPARTMENT OF JUSTICE

DEATHS IN CUSTODY — 2009

BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT

ANNUAL SUMMARY ON INMATES
IN PRIVATE AND MULTI-JURISDICTION JAILS

RTI International

Crime, Violence, and Justice
Research Program

DATA SUPPLIED BY
TITLE

NAME
OFFICIAL
ADDRESS
TELEPHONE

Number and street or P.O. box/Route number

City

Area Code

FAX
NUMBER

Number

State
Area Code

ZIP Code

Number

E-MAIL
ADDRESS

(Please correct any error in name, mailing address, and ZIP Code)

GENERAL INFORMATION
• If you need assistance, call Chris Ellis of the RTI International toll-free at 1–800–###–####,
or e-mail [email protected]
• Please return your completed questionnaire by March 31, 2010. Return all pages by either MAIL or FAX.
FAX (TOLL FREE): 1–888–###–####.
MAIL TO: RTI International, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194

What facilities are included in this data collection?
All confinement facilities including detention centers, jails and other correctional facilities, intended for adults but
sometimes holding juveniles which are either privately owned and operated or administered by two or more governments
(or a board composed of representatives from two or more governments).
• INCLUDE special jail facilities (e.g., medical/treatment/release centers, halfway houses, and work farms).
• INCLUDE inmates held for jurisdictions other than the participating jurisdictions.
• EXCLUDE facilities that are exclusively used as temporary holding or lockup facilities from which inmates are
usually transferred within 72 hours and not held beyond arraignment. (Data on deaths in these facilities will be
obtained in a separate collection.) If your facility holds inmates beyond arraignment, report data on ALL
inmates, including those held in separate holding or lockup areas within your facility.
• EXCLUDE deaths of persons in the process of arrest by your agency if they have not yet been booked into your jail
facility. Arrest-related deaths should be reported using a CJ-11A form. Please contact BJS staff for assistance at
202-307-0765 or “[email protected]”.

Burden Statement
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a
currently valid OMB control number. The burden of this collection is estimated to average 15 minutes per response,
including reviewing instructions, searching existing data sources, gathering necessary data, and completing and
reviewing this form. Send comments regarding this burden estimate or any aspect of this survey, including
suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW,
Washington, DC 20531. Do not send your completed form to this address.

INMATE COUNTS AND DEATHS
1.

How many persons under the supervision of your
jail facility were –

2.

a. CONFINED in your jail facility on December 31, 2009?
• INCLUDE persons on transfer to treatment
facilities but who remain under your
jurisdiction.
• INCLUDE persons out to court while under your
jurisdiction.
• INCLUDE persons held for other jurisdictions.

• To calculate the average daily population, add the number
of persons for each day during the period January 1, 2009,
through December 31, 2009, and divide the result by 365.
• If daily counts are not available, estimate the average
daily population by adding the number of persons held on
the same day of each month and divide the result by 12.

• EXCLUDE inmates on AWOL, escape, or
long-term transfer to other jurisdictions.
• When exact numeric answers are not
available, provide estimates and mark (⌧)
in the box beside each figure.
Inmates on
December 31, 2009

Between January 1, 2009, and December 31, 2009,
what was the average daily population of all jail
confinement facilities operated by your jail?

• If average daily population cannot be calculated as
directed above, then estimate the typical number of
persons held in your jail confinement facilities each day.

Male

• When exact numeric answers are not available, provide
estimates and mark (⌧) in the box beside each figure.

Female

Male

b. ADMITTED to your jail facility during 2009

Average daily population

• INCLUDE new admissions only, i.e., persons
officially booked into and housed in your
facilities by formal legal document and by the
authority of the courts or some other official
agency.

3.

• INCLUDE repeat offenders booked on new
charges.

Between January 1, 2009, and December 31, 2009,
how many persons died while under the supervision
of your jail?
• INCLUDE deaths of ALL persons –

• EXCLUDE returns from escape, work release, medical
appointments/treatment facilities, bail and
court appearances.

CONFINED in your jail facility; or
UNDER YOUR JURISDICTION but out to court or in
special facilities (e.g. hospitals, halfway houses, work
arms, and medical/treatment/release centers); or

• If annual admission figures are not available,
please provide a monthly or weekly admission
count and check the appropriate box.
New admissions
during 2009

Male

WHILE IN-TRANSIT to or from your facilities while under
your supervision.

Female

Male
Annual
Monthly
Weekly

Female

Female

Number of inmate deaths

Annual
Monthly
Weekly

INSTRUCTIONS
• IF NO DEATHS ARE REPORTED in item 3, return the completed form to RTI International.
• IF A FORM CJ-10 "DEATHS IN CUSTODY, 2009–QUARTERLY REPORT ON INMATES IN PRIVATE
AND MULTI- JURISDICTION JAILS" HAS ALREADY BEEN SUBMITTED for each death reported in
item 3, then return this completed FORM CJ-10A to RTI International.
• IF A FORM CJ-10 HAS NOT BEEN SUBMITTED for any of the deaths reported in item 3, please
complete and return a FORM CJ-10 for each of these deaths with your completed FORM CJ-10A.
An additional FORM CJ-10 for 2009 has been included with this questionnaire. If a FORM CJ-10 has not been submitted
for more than 1 death reported in item 3 above, make copies of page 2 and 3 of the enclosed FORM CJ-10 for each
additional death.
FORM CJ-10A (10-5-2009)

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