( )字第 号罪犯______,男(女),______年______月______日生,______族,原户籍所在地______,因____________罪经____________人民法院于______年___________月______ 日以( )____字第______号刑事判决书判处________________,附加__________________,刑期自____________年______月______日交付执行,现押____________________
现经侦查,罪犯_______________在服刑期间涉_________________
主要事实如下:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________