2025 Madera County Security Forms

OFFICE OF THE SHERIFF
RE: Jail Visitor List Information

The Madera County Sheriff's Jail Division is updating the Jail Visitor List Information.

You are required to complete a new application for an access pass and complete the information package attached. Please provide a copy of your California Driver's License or Identification Card. Also, provide a copy of your professional licenses i.e., Bar Card for Attorney's and B.S.I.S. Investigators License for Private Investigators.

If you wish to access the facility for your employer or as a religious volunteer, please be sure to indicate on the application the name of your organization. This information is required to be completed and returned.

Failure to complete and return this information package will result in the removal of your name from the jail list.

If you have any questions, please do not hesitate to contact me.

Brian Esteves, Assistant Sheriff Jail Division
Last Name*
First Name*
Middle Initial
Alias 1
Alias 2
Alias 3
Date of Birth*

MonthDayYear
Date
Place of Birth*
Social Security Number*
Driver's License*
California Bar Card #
B.S.I.S. P/1 #
Sex*
Height*
Weight*
Hair Color*
Eye Color*
Address*
City*
Zip Code*
Home Phone#
Business Phone
Cell Phone
High School Information
School Name
Address
City
State
Zip Code
College/Trade School Information
School Name
Address
Year Graduated
Current Employer
From
To
Address
Phone
Have you ever been arrested or convicted of a Misdemeanor or Felony as an adult?*
If yes, give details*
Are you currently on parole?*
Do you have or had Gang Affiliations?*
List all Scars/Marks/Tattoos and approximately where they are located
Are you related to, or on the visiting list of anyone who is now in the custody of Madera County Jail?*
If yes give name of person and relationship:*
Emergency Contact *
Relationship *
Phone*
Application Certification: Please read before signing. I CERTIFY that statements made by me in this application are true, complete, and correct to the best of my knowledge and belief.
Applicant Signature:*

Clear
Date*

MonthDayYear
Date
RELEASE OF INFORMATION
I am applying for a security clearance with the Madera County Sheriffs Jail Division. I authorize the release and full disclosure of any and all information that you may have concerning me, including information of a confidential or privileged nature, to a duly authorized agent of the Madera County Sheriffs Jail Division. Examples of the types of information I am requesting that you provide are as follows:

Criminal justice, e.g., arrests, detentions, field citations, field interview cards, officer's records, jail/custody booking records, traffic citations and traffic accident information, district attorney records, court records and reports, probation and parole reports and records, laboratory reports and results, and any other criminal justice records, reports, or information source.

Personnel records, e.g., undeleted, and uncensored records and information: e.g., application for employment, background investigation files, time, and sick leave records, claim for worker's compensation and associated reports and documents; performance, disciplinary and adverse action reports (and all allegations of misconduct and failure to act, and the complete and unrestricted contents of any investigation or inquiry made pursuant to those allegations). This specifically means a full and unqualified waiver of confidentiality or non-disclosure contained in any form of settlement agreement, contractual agreement, covenant, or stipulation made between the employee and the employer, even though a court would generally be required before the release of such information.

Academic records, e.g., application for admission, transcript(s) of course work, disciplinary actions and reports and records maintained by campus police/public safety regarding rule violations, driving records, police contacts and criminal conduct.

Financial records, e.g., applications for credit, payment record, credit history, garnishments, government tax reports and records and other liens, bankruptcy, repossessions, collections and any other financial record, report, or information source.

Personal information, e.g., information regarding my character, dependability, honesty, sobriety, integrity, ability to work in stressful situations, interpersonal sensitivity, general physical ability, driving history and reputation as a law-abiding citizen.
Full Name*
All other names you have used:
Signature*

Clear
DATE SIGNED (valid 19 months)*

MonthDayYear
Date
MADERA COUNTY SHERIFF'S OFFICE -JAIL DIVISION ACCESS AGREEMENT
ACKNOWLEDGEMENT OF RISK, GENERAL WAIVER, & AGREEMENT TO HOLD HARMLESS AND INDEMNIFY
I hereby request permission to enter the Madera County Jail for the purpose of Volunteering

understand that there are significant risks involved in entering a jail and these risks have been adequately explained to me. I agree that in return for the information and training that has been provide to me, the permission to enter and to conduct the activities as I have stated above, I will hold harmless and indemnify the county of Madera, specifically the Madera County Sheriff's Office Jail Division.

Further, I hereby waive any claims of a nature that I may have against the County of Madera or any of its employees for personal injury, property loss, or property damage arising from or in connection with my activities within the facility.

Please read below and after all statements:
SEARCHES
Anyone entering the facility is subject to search of their person and/or property and may be scanned at any time.
Upload a jpg/png copy of your photo ID*

Cancelof
Should be Empty:

OFFICE OF THE SHERIFF

High School Information

College/Trade School Information

RELEASE OF INFORMATION

MADERA COUNTY SHERIFF'S OFFICE -JAIL DIVISION ACCESS AGREEMENT

ACKNOWLEDGEMENT OF RISK, GENERAL WAIVER, & AGREEMENT TO HOLD HARMLESS AND INDEMNIFY

SEARCHES