W. Va. Code R. agency 141, tit. 141, ser. 141-49, att. 5
ORDER OF COMMITMENT PURSUANT TO COURT-MARTIAL
TO: Commissioner of the West Virginia
Division of Corrections
The defendant, (NAME, RANK, ADDRESS, & OTHER IDENTIFYING DATA)
has been convicted of violating Uniform State Code of Military Justice (USCMJ), Section(), by West Virginia National Guard Summary Court-Martial.
Therefore, pursuant to Uniform State Code of Military Justice Sections 11 and 58 (W. Va. Code § 15-1E-11 and § 15-1E-58), the sentence of this Court-Martial and the action of convening authority in this matter: YOU ARE DIRECTED TO COMMIT TO CONFINEMENT FORTHWITH THE ABOVE NAMED MEMBER OF THE WEST VIRGINIA NATIONAL GUARD AND TO KEEP SAID PERSON IN YOUR CUSTODY FOR THE FOLLOWING PERIOD OF COMMITMENT: _______DAYS.
SPECIAL INSTRUCTION: UPON COMPLETION, MEMBER IS TO BE RELEASED ON HIS OWN RECOGNIZANCE. MEMBER SHOULD BE PLACED IN STATE, NOT FEDERAL CONFINEMENT IN THE PRISON OR FACILITY.
IF THE DEFENDANT IS NOT DELIVERED INTO YOUR CUSTODY WITH THIS ORDER, YOU ARE AUTHORIZED TO EFFECT HIS ARREST FOR THE PURPOSE OF COMMITMENT.
While committed, the individual shall be subject to the same discipline treatment as other persons so confined and/or committed under the laws of the State of West Virginia.
When the above named individual has been committed to confinement, and again when he has been released, you are requested to notify the following representative of the West Virginia National Guard.
RANK, NAME, UNIT ADDRESS, DAY & NIGHT TIME PHONE NUMBER
By the authority of the Governor of the State of West Virginia and pursuant to the USCMJ (WV Code § 15-1E-1, et seq.), I affix my official signature, this DATE, RANK, NAME, OFFICIAL STATUS, UNIT ADDRESS & SIGNATURE OF SUMMARY COURT-MARTIAL OFFICER OR CONVENING AUTHORITY
The prisoner was received at______hours. DATE:
RANK, NAME, & ORGANIZATION OF CORRECTIONAL OFFICER
W. Va. Code R. agency 141, tit. 141, ser. 141-49, att. 5