Visitor Prisoner Visit Application

Visitor Prisoner Visit Application

RECITALS

WHEREAS, the Facility permits visitation to persons confined under its custody subject to facility rules, security considerations, and applicable law; and

WHEREAS, the Applicant requests authorization to visit the individual identified below and agrees to comply with all facility policies, security screenings, and directives of facility staff; and

NOW, THEREFORE, the Applicant submits the following information and certifications for the purpose of obtaining visitation privileges.

APPLICANT INFORMATION

Date of Birth:    Government ID Type:    ID Number:

Primary Phone:    Alternate Phone:

PRISONER INFORMATION

Prisoner ID / Booking Number:    Housing Unit / Cell:

REQUESTED VISIT

Requested Visit Date:    Preferred Arrival Time:    Estimated Duration:

BACKGROUND & AUTHORIZATIONS

Have you ever been convicted of a felony?   Yes   No

Applicant consents to a background check and search of person and belongings as a condition of visitation.   I consent

VEHICLE INFORMATION (IF APPLICABLE)

Vehicle Make/Model:    License Plate:

EMERGENCY CONTACT

Relationship:    Phone:

CONDITIONS, CERTIFICATION, AND AUTHORIZATION

By signing below, Applicant certifies under penalty of law that all information provided on this application is true and complete to the best of Applicant's knowledge. Applicant understands that making a false statement or omission may result in denial of visitation privileges and may be subject to criminal prosecution.

Applicant acknowledges and agrees that visitation is a privilege subject to search, monitoring, and termination by facility staff. Applicant consents to search of person, vehicle, and personal property prior to or during visits. Applicant releases the Facility, its officers, employees, and agents from liability for actions taken in good faith to enforce visitation rules and security measures.

Applicant authorizes the Facility to verify identification, conduct criminal background or warrant checks, and to consult records necessary to determine eligibility for visitation. The Facility reserves the right to deny, suspend, or revoke visitation privileges for safety, security, or disciplinary reasons.

ACKNOWLEDGMENTS

Applicant acknowledges receipt of the Facility's visitor rules and understands that failure to comply with those rules may result in immediate removal and potential prohibition from future visitation. Applicant agrees to follow all posted rules and staff directions.

FACILITY USE ONLY

Application Received By:

Date Received:

Approved: Yes    No    If No, reason:

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