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

OMB No. 1121‐0094 Approval Expires ##/##/201# 

DEATHS IN CUSTODY—2015
ANNUAL SUMMARY ON INMATES IN
PRIVATE AND MULTIJURISDICTIONAL JAILS

Form CJ-10A

U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:

FORM COMPLETED BY—

RTI INTERNATIONAL

Name

Title

Official
Address

Telephone

City

FAX

State

Zip

Email

Instructions for completion and submission
FOR EACH ITEM—
 If the answer to a question is “none” or “zero,” write “0” in the space provided.
 When exact numeric answers are not available, provide estimates and mark ( X ) in the checkbox beside each number that is
estimated. For example 1,234 
Please submit your completed form(s) within 30 days of receipt. You may submit your annual summary in one of these ways:
ONLINE: Complete this form online at: https://bjsdcrp.rti.org
EMAIL: [email protected] 
FAX (TOLL-FREE): (866) 800-9179

MAIL: RTI International, Attn: Data Capture
Project Number: 0213149.001.400.402.100
5265 Capital Boulevard
Raleigh, NC 27690-1652

If you need assistance, contact Matt Bensen of RTI International toll-free at 1-800-344-1387 or [email protected].

What to include and exclude in this data collection
INCLUDE—
 Confinement facilities—including detention centers, jails, and other correctional facilities—intended for adults but sometimes holding
juveniles, that are either privately owned and operated or administered by two or more governments (or a board composed of
representatives from two or more governments).
 All jails and city/county correctional centers that hold inmates beyond arraignment. Report data on all inmates, including those held in
separate holding or lockup areas within your facilities.
 Special jail facilities (e.g., medical/treatment/release centers, halfway houses, and work farms).
 Temporary holding or lockup facilities if they are part of your combined function.
 Inmates held for other jurisdictions, including federal authorities, state prison authorities, and other local jail jurisdictions.
EXCLUDE—
X Facilities that are exclusively used as temporary holding or lockup facilities, where inmates are generally held for less than 72 hours
and not held beyond arraignment.

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.

«AGENCY ID» 

INMATE COUNTS AND DEATHS

1. On December 31, 2015, how many persons under the
supervision of your jail were CONFINED in this facility?



INCLUDE—





Persons on transfer to treatment facilities but who
remain under your jurisdiction
Persons held for other jurisdictions
Persons in community-based programs (e.g., work
release, day release, or drug/alcohol treatment) who
return to jail at night
Persons out to court while under your jurisdiction.

EXCLUDE—
X
X
X

Persons under your jurisdiction who are boarded
elsewhere
Inmates who are AWOL, escaped, or on long-term
transfer to other jurisdictions
Persons in community-based programs run by this
facility (e.g., electronic monitoring, house arrest,
community service, day reporting, or work programs)
who do NOT return to jail at night.

Inmates on
December 31,
2015

3. On December 31, 2015, how many persons CONFINED in
this facility were held for—

Estimate

Females:  

Estimate

Males:

INCLUDE contractual, temporary, courtesy, or ad hoc
holds for other agencies.
Count persons with multiple holds only once with priority
being federal, state, tribal, and local.



a. U.S. Immigration and
Customs Enforcement:

Estimate

b. U.S. Marshals Service:

Estimate

c. All other holds (state and
federal prison, Bureau of
Indian Affairs, or any holds
for other jail jurisdictions):

Estimate

4. Between January 1, 2015, and December 31, 2015, what
was the average daily population of this facility?


INCLUDE inmates who participated in weekend
programs that allow offenders to serve their sentences
of confinement only on weekends (e.g., Friday–Sunday).
To calculate the average daily population, add the
number of persons for each day between January 1,
2015, and December 31, 2015, 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.
If average daily population cannot be calculated as
directed above, then estimate the typical number of
persons held in this facility each day.





2. How many persons under the supervision of your jail were
ADMITTED to this facility during 2015?



INCLUDE—




Persons officially booked into and housed in this
facility by formal legal document and by the authority
of the courts or some other official agency
Repeat offenders booked on new charges
Persons serving a weekend sentence coming into the
facility for the first time.

EXCLUDE—
X

Returns from escape, work release, medical
appointments/treatment facilities, furloughs, bail/bond
releases, and court appearances.

New ANNUAL
admissions
during 2015

Males:

Estimate

Females:

Estimate

Average daily
population
during 2015

Males:

Estimate

Females:

Estimate

5. Between January 1, 2015, and December 31, 2015, how
many persons died while under the supervision of this
facility?
INCLUDE deaths of ALL persons—





CONFINED in this facility
UNDER THE SUPERVISION of this facility, but out to
court or in special facilities (e.g., hospital, hospice, or
nursing home; treatment facility; residential
community center; residential work release or house
arrest program; or release center)
WHILE IN TRANSIT to or from this facility while
under your supervision.

EXCLUDE—
X

Number of
inmate
deaths
during 2015

Deaths of persons in the process of arrest by your
agency if they have not yet been booked into this
facility. Arrest-related deaths should be reported
using a CJ-11A form.

Males:
Females:

«AGENCY ID»