NPCS Inmate Intake for Case Evualation
If you don't know the answer to any of the questions below, that's okay. Please type "don't know" in the field or leave it blank.
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Full Name of the Prisoner
Name
First Name
Middle Name
Last Name
DOC # / Inmate Number
What state is the prisoner incarcerated in?
Please provide the incarcerated person's complete mailing address where he or she can receive mail.
Convicted of what crime(s)?
Length of Sentence?
Is the prisoner a Male or Female?
Male
Female
Transgender
Prisoner's Age?
Been incarcerated for how long?
Does the prisoner currently have a parole hearing scheduled? If yes, what is the month and year of the parole hearing?
Has the incarcerated person received any misconducts?
Is the prisoner wanting assistance with? Check all that apply
A parole package
Request for Sentence Commutation
Structured Re-Entry Assessment (SRA) (Professional assessment of rehabilitation)
If the prisoner has an excessive sentence, please briefly explain the reasons why the sentence is excessive.
If the prisoner is innocent, please list here any evidence of innocence, such as new evidence, affidavits, perjured testimony, ect.
Did the prisoner...
Pled Guilty pursuant to a plea agreement
Went to a jury trial
Pled No contest
Blind Plea
Your Name
First Name
Last Name
What is your relationship to the prisoner?
Family Member
Friend
Husband or Wife
Attorney
Clergy
Okay to contact you by phone?
Your Phone Number
Please enter a valid phone number.
Your e-mail address?
example@example.com
Please verify that you are human
*
Submit
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