Department Forms

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Forms are official Department documents. Below is a list of available forms.

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• 01 Series Forms
• 02 Series Forms
• 03 Series Forms
• 05 Series Forms
• 06 Series Forms
• 07 Series Forms
• 09 Series Forms
• 10 Series Forms
• 11 Series Forms
• 13 Series Forms
• 14 Series Forms
• 16 Series Forms
• 17 Series Forms
• 19 Series Forms
• 20 Series Forms
• 21 Series Forms
• Forms in Spanish/Formularios y español
• Unofficial Agency Forms

01 Series Forms

• DOC 01-008 Agency Denial/Exemption Log (Rev. 03/11/2022)
• DOC 01-009 Central File Archive Checklist (Rev. 12/17/2021)
• DOC 01-010 Audit Checklist - Central File (Rev. 03/17/2022)

02 Series Forms

• DOC 02-001 Cell Phone Agreement (Rev. 05/16/2022)
• DOC 02-022 Partial Confinement Mileage Log (Rev. 08/09/2023)
• DOC 02-024 Employer Vehicle Use Authorization (Rev. 08/09/2023)
• DOC 02-025 Sex Offender Treatment and Assessment Programs Limits of Confidentiality (Rev. 07/22/2022)
  • Límites de Confidencialidad de Los Programas de Tratamiento y Evaluación de Delincuentes Sexuales
• DOC 02-027 Virtual/Telephonic Hearing Request (Rev. 10/06/2022)
• DOC 02-029 Virtual Hearing Acknowledgement/Waiver (Rev. 10/06/2022)
• DOC 02-187 Individual Reentry Plan (Rev. 09/23/2022)
  • Plan de Reingreso Individual
• DOC 02-195 Victim/Survivor Dialogue Meeting Application (Rev. 07/27/2025)
• DOC 02-243ES Notice of Continued Obligations/Restrictions (Rev. 04/21/2025)
• DOC 02-247 Law Library Request for Priority Access (Rev. 11/05/2020)
• DOC 02-265 – Community Compensation Program Member Acknowledgement form (Rev. 3/30/2023)
• DOC 02-266 – Community Compensation Program Application form (Rev. 3/30/2023)
• DOC 02-267 – Community Member Compensation Request form (Rev. 3/30/2023)
• DOC 02-322 Receipt of Handbook (Rev. 9/27/2024)
  • Recepcion del Manual
• DOC 02-330 Sex Offender Treatment and Assessment Programs Informed Consent for Prison Treatment (Rev. 07/22/2022)
  • Programas de Evaluación y Tratamiento de Delincuentes Sexuales Consentimiento Informado Para el Tratamiento en Prisión
• DOC 02-335 Acknowledgment of Receipt of State/Federal Identification/Vital Records (Rev. 04/02/2025)
• DOC 02-336 Reentry Housing Assistance Program Application (Rev. 8/13/2025)
• DOC 02-353 Electronic Monitoring Contract (Rev. 01/17/2024)
• DOC 02-354 Care and Use of Radio Frequency Equipment (Rev. 06/10/2021)
• DOC 02-361 Partial Confinement Conditions (Rev. 07/27/2025)
  • Condiciones de Confinamiento Parcial
• DOC 02-363 DCYF – Authorization for Release of Information (Rev. 08/27/2020)
• DOC 02-364 Daily Itinerary – Community Parenting Alternative (Rev. 09/18/2020)
• DOC 02-365 Family and Offender Sentencing Alternative Job Search Log (Rev. 01/12/2022)
• DOC 02-368 Home Visitor Log (Rev. 12/03/2021)
  • Registro de Visitas al Domicilio
• DOC 02-369 Search Waiver (Rev. 06/16/2022)
  • Renuncia a Los Derechos de Registro
• DOC 02-371 Personal Vehicle Use Authorization (Rev. 10/10/2023)
  • Autorizacion Para Uso de Un Vehiculo Personal
• DOC 02-374 Personal Property Disposal (Rev. 6/19/2024)
  • Disposición de Propiedad Personal
• DOC 02-384 Housing Protocol for Transgender, Intersex, and Non-binary Individuals (Rev. 9/14/2023)
• DOC 02-385 Housing Protocol for Transgender, Intersex, and Non-binary Individuals (Rev. 9/14/2023)
• DOC 02-391 Veterans Unit Application (Rev. 09/27/2023)
• DOC 02-394 Facilitator Dialogue Meeting Application (Rev. 07/20/2021)
• DOC 02-395 Accountability Letter Bank - Request to Participate (Rev. 07/27/2025)
• DOC 02-398 Transport Bag Inventory (Rev. 12/06/2019)
• DOC 02-399 Interstate Compact Notice of Probable Cause Hearing, Rights, and Waiver (Rev. 12/20/2021)
• DOC 02-400 Notice of PREA Investigation Findings (Rev. 04/19/2022)
• DOC 02-401 Juvenile Board Declaration of Intent (Rev. 07/28/2020)
• DOC 02-402 Sex Offender Treatment and Assessment Programs Informed Consent for Community Treatment (Rev. 07/22/2022)
  • Consentimiento Informado Para el Tratamiento Comunitario de Los Programas de Tratamiento y Evaluación de Delincuentes Sexuales
• DOC 02-406 Sex Offender Treatment and Assessment Programs Release of Confidential Information (Rev. 07/22/2022)
  • Divulgación de Información Confidencial de Los Programas de Tratamiento y Evaluación de Delincuentes Sexuales
• DOC 02-407 Statement to the Indeterminate Sentence Review Board (Rev. 12/13/2019)
• DOC 02-409 Reentry Goals - Community Parenting Alternative (Rev. 11/20/2020)
• DOC 02-410 Community Parenting Alternative Screening (Rev. 6/19/2024)
• DOC 02-413 Notice Future Supervision (Rev. 10/14/2021)
  • Aviso de Futura Supervision
• DOC 02-420 Preferences Request (Rev. 01/31/2024)
  • Solicitud De Preferencias
• DOC 02-422 Transgender, Intersex, and Non-binary Housing Multi-Disciplinary Team (Rev. 07/17/2023)

03 Series Forms

• DOC 03-031 Criminal Disclosure (Rev. 03/04/2022)
• DOC 03-039 Report of Contact/Relationship (Rev. 3/20/2024)
• DOC 03-151 Hazard Report (Rev. 02/11/2022)
• DOC 03-161 Volunteer Safety Orientation Information (Rev. 02/11/2022)
• DOC 03-421 Volunteer Confidentiality Agreement (Rev. 03/22/2022)
• DOC 03-440 Volunteer Application and Registration (Rev. 03/22/2022)
• DOC 03-441 Volunteer Orientation Checklist (Rev. 03/22/2022)
• DOC 03-443 Non-Department Personnel Acknowledgment for Off-Site Work Crews (Rev. 02/02/2022)
• DOC 03-472A Confined Space Entry Site-Specific Training - Incarcerated Worker (Rev. 02/03/2021)
• DOC 03-478 PREA Acknowledgement (Rev. 04/19/2022)
• DOC 03-484 Interview Acknowledgment (Rev. 7/8/2025)
• DOC 03-506 Sexual Misconduct and Institutional Employment/Service Disclosure (Rev. 03/04/2022)
• DOC 03-523 PREA Disclosure and Training Acknowledgement for Volunteers (Rev. 04/19/2022)

05 Series Forms

• DOC 05-047 Project Request Application (Rev. 09/2020)
• DOC 05-062 Property (Rev. 05/22/2023)
  • Propiedad Del Interno/Interna
• DOC 05-066 Public Records Request (Rev. 4/1/2024)
  • Solicitud de Registros Publicos
• DOC 05-092 Administrative Segregation Review (Rev. 03/06/2020)
  • Revision de Segregacion Administrativa
• DOC 05-093 Disciplinary Hearing Notice/Appearance Waiver (Rev.02/22/2023)
  • Aviso De Audiencia Disciplinaria/Renuncia De Comparecencia
• DOC 05-094 Witness Statement (Rev. 02/22/2023)
  • Declaracion De Testigo
• DOC 05-113ES Request for Interpreter (Rev. 03/06/2020)
  • Solicitud Para Servicio De Intérprete
• DOC 05-121ES Request for Department Advisor (Rev. 03/06/2020)
  • Solicitud Para Un Asesor Del Departamento
• DOC 05-165 Resolution Request (Rev. 03/06/2025)
  • Solicitud de Resolución
• DOC 05-370 Request for Criminal History Record Information WASIS/NCIC III Check NCIC/WACIC Check (Rev. 07/27/2025)
• DOC 05-512 Partial Confinement Orientation Checklist (Rev. 07/27/2025)
  • Lista de Comprobación de Orientación en Confinamiento Parcial
• DOC 05-666ES Request for Interpretation/Translation by an Incarcerated Individual (Rev. 08/04/2020)
  • Solicitud de Interpretacion/Traduccion de Un Individual Encarcelado
• DOC 05-673 Escorted Leave Reimbursement Request (Rev. 08/05/2020)
• DOC 05-685 Rules for Contact with Victims or Minors (Rev. 02/20/2020)
  • Reglas Para El Contacto Con Victimas O Menores De Edad
• DOC 05-686 Chaperone/Supervisor of Contact Agreement of Responsibilities (Rev. 11/04/2020)
  • Chaperon/Supervisor De Contacto Acuerdo De Responsabilidades
• DOC 05-688 Chaperone/Supervisor of Contact Requirements (Rev. 02/20/2020)
  • Requisitos Del Acompañante/Supervisor De Contacto
• DOC 05-698 Affidavit for Disposition of Personal Property (Rev. 04/05/2022)
• DOC 05-702 Contact/Safety Plan (Rev. 02/20/2020)
  • Plan de Contacto/Seguridad
• DOC 05-703 Termination of Contact with Minors Appeal (Rev. 02/20/2020)
• DOC 05-753 Polygraph Examination - Authorization for Release of Information (Rev. 01/25/2021)
  • Prueba de Polígrafo - Autorización Para Divulgación de Información
• DOC 05-764 Work Crew Expectations Declaration (Rev. 6/19/2024)
  • Declaracion De Expectativas De Cuadrilla
• DOC 05-780 Global Positioning System Rules (Rev. 01/17/2024)
• DOC 05-781 Internet Access Rules (Rev. 11/03/2022)
• DOC 05-793 Funeral Trip/Deathbed Visit Worksheet and Checklist (Rev. 08/05/2020)
• DOC 05-831 Attorney Representation - Consent for Release of Information (Rev.05/16/2023)

06 Series Forms

• DOC 06-014 Multiple Incarcerated Individual Funding Request (Rev. 6/6/2024)
• DOC 06-065 Cost of Supervision Refund Address Verification (Rev. 10/8/2024)
  • Costo de Reembolso de Supervisión Verificación de Dirección
• DOC 06-070 Mandatory Savings Account Exemption (Rev. 4/7/2025)
• DOC 06-071 Mandatory Savings Account Access (Rev. 6/6/2024)
  • Acceso Obligatorio A La Cuenta De Ahorros
• DOC 06-073 Request for Advance and Promissory Note (Rev. 02/11/2022)
  • Solicitud De Anticipo Y Pagaré
• DOC 06-074 Check Request (Rev. 10/12/2023)
  • DOC 06-074H Check Request (half sheet) (Rev. 10/12/2023)
• DOC 06-075ES Request to Transfer Funds (Rev. 10/06/2022)
  • Peticion Para Transferencia De Fondos
• DOC 06-076 Education Subaccount Withdrawal Request (Rev. 3/3/2020)
• DOC 06-077 Request to Reissue/Cancel Check (Rev. 6/6/2024)
• DOC 06-080 Deposit Rejection Notice (Rev. 6/6/2024)
• DOC 06-081 Compassion Transfer Expense (Rev. 2/7/2022)

07 Series Forms

• DOC 07-011 Request for Information Regarding Tribal Deposits (Rev. 6/6/2024)
• DOC 07-024 Conditions, Requirements, and Instructions (Rev. 02/22/2023)
  • Condiciones, Requisitos, E Instrucciones
• DOC 07-025 Chaperone Orientation Certificate (Rev. 01/17/2024)
• DOC 07-033 Prohibited Contact Definitions (Rev. 01/17/2024)
• DOC 07-035 Drug Offender Sentencing Alternative Compliance Review (Rev. 01/14/2022)
• DOC 07-037 Classification Appeal (Rev. 07/17/2023)
  • Apelacion De Clasificacion
• DOC 07-040 Application for Advance Notification and Victim Services (Rev. 05/28/2025)
• DOC 07-043 Trip Proposal (Rev. 07/15/2025)
  • Accommodated Trip Proposal
• DOC 07-046 Community Contact/Chaperone Proposal (Rev. 01/17/2024)
  • Propuesta de Contacto Comunitario/Acompañante
• DOC 07-053 Release/Transfer Needs Survey (Rev. 09/23/2022)
• DOC 07-054 Acknowledgment of Community Custody Supervision Compliance Credit (SCC) (Rev. 02/29/2024)
  • Reconocimiento de Crédito De Supervisión de Cumplimiento de la Custodia Comunitaria

09 Series Forms

• DOC 09-012ES Request for Unclaimed Property (Rev. 6/6/2024)
  • Solicitud De Propiedad No Reclamada
• DOC 09-052 Miranda Warning Waiver (Rev. 09/26/2019)
  • E/S Renuncia a La Advertencia Miranda (Rev. 09/26/2019)
• DOC 09-065ES Notice of Significant Legal Document (Rev. 08/04/2020)
  • Notificacion de un Documento Significativo Legal
• DOC 09-164 Responsibilities of Furlough Sponsors (Rev. 08/05/2020)
• DOC 09-227 Deferred Decision Waiver (Rev. 08/03/2021)
• DOC 09-230 Partial Confinement Notice of Allegations, Hearing, Rights, and Waiver (Rev. 6/19/2024)
  • Confinamiento Parcial Notificacion de Alegaciones, Audiencia, Derechos y Renuncia
• DOC 09-231 Notice of Allegations, Hearing, Rights, and Waiver (Rev. 08/03/2021)
  • Notificacion de Alegaciones, Audiencia, Derechos y Renuncia
• DOC 09-242ES General Authorization for Release of Information (Rev. 04/07/2025)
• DOC 09-274 Notification of Department Violation Process (Rev. 09/28/2021)
  • Notificación de Proceso de Infracción del Departamento
• DOC 09-275 Appeal of Department Violation Process (Rev. 07/17/2023)
  • Apelacion al Proceso de Infraccion del Departamento
• DOC 09-288 Board - Petition for Review (Rev. 07/28/2020)
• DOC 09-304 Board - Rights and Privileges for Parole/Community Custody Violation/Revocation Hearings (Rev. 10/20/2021)
• DOC 09-307 Board - Request for Appointment of Attorney (Rev. 10/20/2021)
• DOC 09-308 Board - Supplement (Rev. 10/20/2021)
• DOC 09-485 Authorization for Release of Custodial Information (Rev. 10/31/2022)

10 Series Forms

• DOC 10-031 Correctional Industries Application for Work Programs (Rev. 10/06/2023)
• DOC 10-114 Correctional Industries Work Program Recommendation Referral (Rev. 06/21/2023)
• DOC 10-116 Job Specialty Training Record (Rev. 02/11/2022)
• DOC 10-117 Safety Orientation Worksheet (Rev. 02/11/2022)
• DOC 10-118 Shop Rules and Requirements (Rev. 02/11/2022)
• DOC 10-120 Incident Camp Summary Report (Rev. 06/19/2024)
• DOC 10-122 Tool/Equipment/Process Specialty Training Outline (Rev. 02/11/2022)

11 Series Forms

• DOC 11-012 Release/Transfer Sponsor Orientation Checklist (Rev. 07/27/2025)
  • Liberación/Transferencia Lista de Control de Orientación Del Patrocinador 
• DOC 11-025 Graduated Reentry Job Search Log (Rev. 11/20/2020)
  • Reingreso Graduado Registro de Busqueda de Empleo
• DOC 11-039 Graduated Reentry Criteria (Rev. 06/29/2022)
• DOC 11-045 Special Sex Offender Sentencing Alternative Informed Consent (Rev. 09/21/2021)
• DOC 11-046 Mental Health Sentencing Alternative Agreement (Rev. 02/23/2022)
• DOC 11-050 Emergency Caregiver Agreement (Rev. 11/20/2020)
  • Acuerdo De Guardian De Emergencia
• DOC 11-065 Graduated Reentry Participant Agreement (Rev. 07/27/2025)
  • Reingreso Graduado Acuerdo Del Participante
• DOC 11-080 Social Media and Electronic Device Monitoring Agreement (Rev. 03/04/2022)
  • Acuerdo De Monitoreo De Redes Sociales Y Dispositivos Electronicos

13 Series Forms

• DOC 13-035 Authorization for Disclosure of Health Information (Rev. 03/13/2023)
  • Autorizacion Para Revelar Informacion Sobre La Salud
• DOC 13-159 Request for Health Information (Rev. 11/07/2022)
• DOC 13-392 Durable Power of Attorney for Health Care (Rev. 3/26/2019)
• DOC 13-423 Health Services Kite (Rev. 07/27/2025)
  • “Kite” Para Servicios De Salud
• DOC 13-460ES Patient Request for Outside Health Services (Rev. 4/25/2023)
• DOC 13-463 Patient-Paid Healthcare Hospital Information (Rev. 4/25/2023)
• DOC 13-471 Self-Wellness Check (Rev. 03/10/2020)
  • Autoevaluación de Bienestar
• DOC 13-472 Patient-Paid Durable Medical Equipment (DME) (Rev. 4/25/2023)
  • Equipo Medico Duradero Pagado por el Paciente
• DOC 13-507 Health Records Request Continuity of Care (Rev. 3/27/2019)
• DOC 13-521 Consent for Hormone Treatment for Gender Dysphoria and/or Transgender Identification (Rev. 1/11/2021)
  • Consentimiento para Tratamiento Hormonal para Disforia de Género y/o Identificación Transgénero
• DOC 13-578 Patient Appeal of Care Review Committee Decision (Rev. 01/09/2020)
  • Apelación del Paciente a la Decision del Comite de Revision de Cuidados de Salud
• DOC 13-584 Patient Appeal of Accomodation Review Committee Decision (Rev. 6/23/2021)
  • Apelación del el Paciente a la Decisión del Comité de Revisión de Alojamiento
• DOC 13-659 Gender-Affirming Property Issuance Request (Rev. 2/10/2025)

14 Series Forms

• DOC 14-002ES Acknowledgment of Drug/Alcohol Testing - Total/Partial Confinement (Rev. 7/20/2021)
  • Reconocimiento de Pruebas de Drogas/Alcohol en Confinamiento Total/Parcial
• DOC 14-003 Confidentiality Statement (Rev. 3/13/2024)
• DOC 14-021 Admission of Drug/Alcohol Use/Possession (Rev. 4/8/2024)
• DOC 14-035 Acknowledgment of Drug/Alcohol Testing – Field (Rev. 07/17/2023)
  • Reconocimiento de Pruebas de Drogas/Alcohol en la Comunidad
• DOC 14-035A Less Restrictive Alternative Drug/Alcohol Testing Acknowledgment (Rev. 07/11/2022)
• DOC 14-039 Substance Use Disorder Treatment Participation Requirements (Rev. 7/26/2024)
  • Requisitos de Participacion en el Tratamiento de Trastorno por Uso de Sustancias
• DOC 14-042 Prison Drug Offender Sentencing Alternative Agreement (Rev. 07/26/2024)
• DOC 14-049 Boarder Health History Screening (Rev. 10/14/2020)
• DOC 14-053 Use of Medical Cannabis Verification (Rev. 02/24/2023)
• DOC 14-055 Suitability for Medical Cannabis Use (Rev. 02/24/2023)
• DOC 14-172 Substance Abuse Recovery Unit Compound Release of Confidential Information (Rev. 9/03/2024)
  • Complejo de La Unidad de Recuperación de Abuso de Sustancias Divulgacion de Informacion Confidencial
• DOC 14-179 Residential Drug Offender Sentencing Alternative Examination Report (Rev. 3/4/2022)
• DOC 14-204 Request for Laboratory Confirmation (Rev. 4/4/2024)
• DOC 14-213 Visitor Medication and Durable Medical Equipment (Rev. 3/20/2024)
  • Cuestionario Sobre Medicacion al Visitante y Equipo Medico Duradero

16 Series Forms

• DOC 16-347 Monthly Safety and Sanitation Inspection (Rev. 02/11/2022)
• DOC 16-348 Quarterly Safety and Sanitation Inspection (Rev. 02/11/2022)
• DOC 16-348HQ Headquarters Quarterly Safety and Sanitation Inspection (Rev. 02/11/2022)
• DOC 16-352 Outdoor Heat Exposure Awareness Training (Rev. 3/12/2024)
  • Exposicion al Calor al Aire Libre Curso de Capacitacion

17 Series Forms

• DOC 17-074 Disciplinary Hearing Appeal (Rev. 05/16/2023)
  • Apelacion de Audiencia Disciplinaria
• DOC 17-086 Department Interpreter Authorization for General Infraction Hearings/Stipulated Agreement (Rev. 08/04/2020)
• DOC 17-088 Disciplinary Hearing Audio Request Log (Rev. 07/22/2022)

19 Series Forms

• DOC 19-084 Legal Copy/Indigent Postage/Scanning Request (Rev. 10/06/2022)

20 Series Forms

• DOC 20-060 Visitor Application (Rev. 9/18/2024)
• DOC 20-073 Standard Rules (Rev. 7/27/2025)
  • Reglas Estándar
• DOC 20-084 Social Outing Request and Responsibilities (Rev. 04/18/2023)
  • Peticion Y Responsabilidades De Una Excursion Social
• DOC 20-102 Schedule/Plan (Rev. 10/10/2023)
• DOC 20-103 Job Search Pass (Rev. 10/12/2023)
• DOC 20-155 Intake/Pre-Sentence Report Personal Information Sheet (Rev. 07/17/2023)
  • Ingreso/Informe Precondenatorio Hoja De Informacion
• DOC 20-169 Reentry Center Sponsor Application (Rev. 11/15/2021)
  • Reclusorio Nocturno Solicitud para Visitantes y Patrocinadore
• DOC 20-171 Reentry Center Sponsor Interview/Orientation (Rev. 11/15/2021)
• DOC 20-181 Minor Visitor Application (Rev. 04/2021)
• DOC 20-182 Government Designated Escort Application (Rev. 01/30/2025)
• DOC 20-213 Marriage/State Registered Domestic Partnership Application for Intended Spouse/State Registered Domestic Partner Use (Rev. 08/31/2023)
  • Solicitud de Matrimonio/Union Civil de Pareja Domestica Registrada en el Estado. Uso del Pretendido Cónyuge/Pareja Domestica Registrado en el Estado
• DOC 20-215 Marriage/State Registered Domestic Partnership Approval Release of Information (Rev. 08/31/2023)
  • Matrimonio/Union Civil de Pareja Domestica Inscrita Aprobacion para la Revelacion de Informacion
• DOC 20-218 Marriage/State Registered Domestic Partnership Approval Routing (Rev. 08/13/2020)
• DOC 20-219 Acknowledgment of DOC 590.200 Marriages and State Registered Domestic Partnerships (Rev. 08/13/2020)
  • Matrimonio/Pareja Domestica Registrada en el Estado Aprobación de Divulgación de Información
• DOC 20-230 Record of Volunteer Services for Incarcerated Individual (Rev. 12/28/2020)
• DOC 20-235 Work Program Assignment/Change/Termination (Rev. 06/20/2023)
• DOC 20-279 Visitor Consent to Medical Treatment and Waiver of Liability (Rev. 3/20/2024)
  • Visitantes Consentimiento Para Tratamiento Médico y Renuncia de Responsabilidad
• DOC 20-305 Correspondence Study Request (Rev. 10/02/2024)
  • Solicitud Para Tomar Cursos Por Correspondencia
• DOC 20-309 Correspondence Education College Provider/Student Agreement (Rev. 10/02/2024)
• DOC 20-329 Residential Parenting Program Community Visit Authorization (Rev. 07/17/2020)
• DOC 20-332 Residential Parenting Program Participant Application (Rev. 07/17/2020)
• DOC 20-336 Residential Parenting Program Emergency Caregiver Application (Rev. 07/17/2020)
• DOC 20-414 Intake Questionnaire (Rev. 09/01/2022)
  • Cuestionario de Ingreso
• DOC 20-431ES Food Services Training Record (Rev. 05/23/2019)
  • Registro De Entrenamiento De Servicios De Comida
• DOC 20-440 Native American Heritage Questionnaire (Rev. 9/28/2023)
• DOC 20-441 Parent/Guardian Consent for Minor Visit and/or Escort (Rev. 3/7/2024)
  • Permiso del Padre/Guardian Legal para Visita de Un Menor y/o Acompañante
• DOC 20-450 Approval for Visits by Current/Former Employee, Contract Staff, or Volunteer (Rev. 1/4/2023)

21 Series Forms

• DOC 21-139ES Property Disposition (Rev. 12/21/2023)
  • Disposicion De Propieded
• DOC 21-141 Property Appeal (Rev. 9/1/2023)
• DOC 21-148 Extended Family Visit Property Waiver (Rev. 10/01/2020)
• DOC 21-379ES Report of Prison Rape Elimination Act (PREA) Allegation to an Outside Agency (Rev. 04/19/2023)
• DOC 21-415 Extended Family Visit Application/Acknowledgment (Rev. 05/05/2025)
• DOC 21-421ES Prison Telephone Use Acknowledgment (Rev. 05/16/2022)
• DOC 21-473ES Kite (Rev. 12/31/2023)
  • Kite
• DOC 21-503 Special Escorted Leave Reimbursement Request (Rev. 01/06/2023)
• DOC 21-565 Hazard Communication Label and Safety Data Sheet Training (Rev. 07/10/2020)
  • Etiqueta de Comunicación de riesgos y Entrenamiento de Ficha de Datos de Seguridad
• DOC 21-566 Security Concerns/Suggestions (Rev. 06/26/2019)
• DOC 21-572 Request for Inter-Facility Telephone Communication (Rev. 03/01/2023)
• DOC 21-660 Off-Site Work Crew Security Audit (Rev. 07/03/2024)
• DOC 21-662 PREA Database Access Confidentiality Agreement (Rev. 01/27/2022)
• DOC 21-754ES Telephone Action (Rev. 05/16/2022)
• DOC 21-757 Publication Rejection Appeal (Rev. 12/31/2023)
  • Apelación De Una Publicación Rechazada
• DOC 21-761 Prohibited Contact Review (Rev. 04/25/2022)
• DOC 21-787 Special Visit Request (Rev. 8/30/2023)
  • Peticion Para Una Visita Especial
• DOC 21-964 Reentry Community Services Program Transition Plan (Rev. 08/20/2021)
• DOC 21-966 Donation Approval Request (Rev. 02/12/2025)
• DOC 21-992 Prison Orientation Checklist (Rev. 12/27/2021)
  • Lista de Temas de la Orientacion en Prisión

Unofficial Agency Forms

• Lodging & Transportation Reimbursement Application