SOP 220.03-att-4: Special Parole Review Recommendation Form

SOP 220.03
Attachment 4

Page 1 of 2

07/26/22
# Department of Corrections Special Parole Review Recommendation Form:

Offender’s Name: ______________________________________________

GDC ID Number: _____________________________________________

(Signature/ Printed Name/ Title) of Classification Committee Member Making
Recommendation :

__________________/_______________________/_________________

Date: _________________________

Preliminary Consideration Data:
(Check Yes or No for Questions 1 thru 7)

1. Yes__ No__ Is the above-named offender serving a sentence of Life without possibility of
Parole?
2. Yes__ No__ Was the above-named offender convicted under SB 441?

Note: If the answer (Yes) has been given for questions 1 or 2,
this recommendation should be terminated.

3. Yes__ No__ If the offender is serving a Life sentence, he/she must have served the majority
of his/her set off period, i.e., 5 of 8 years, 4 of 6 years, etc. Has the offender met this
requirement?
4. Yes__ No__ Has the offender served 24 months since their last parole consideration?
5. Yes__ No__ Has the offender been at his/her present (recommending) facility for a minimum
of 12 months, of which time he/she has not received a disciplinary report?
6. Yes__ No__ Does the offender have documented in his/her file, exemplary conduct via staff
completing Work Activity Performance Reports (WAPR’s)?

Note: If the answer (No) has been given for any one of
questions 3 thru 7, this recommendation should be
terminated.

Summary of Exemplary Conduct of Offender:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Note: Attach copies of all supporting documents
(Work Activity Report(s), etc.)

Retention Schedule: Upon completion, a copy of this form will be placed in the offender’s institutional file.

SOP 220.03
Attachment 4

Page 1 of 2

07/26/22

Date submitted to Warden: __________________________________

_I. Warden’s Recommendation_ :

(Circle One) Approve / Disapprove

Reason for Disapproval: ________________________________________
______________________________________________________________________________
____________________________________________________

_________________________________________________________
Warden’s Signature/ Date:

Date forwarded to Regional Office: _________________________

_II. Regional Director’s Recommendation_ :

(Circle One) Approve / Disapprove

Reason for Disapproval: _________________________________________
______________________________________________________________________________
____________________________________________________

_________________________________________________________
Regional Director’s Signature/Date
____________________________________________________________

Date forwarded to Facilities Operations Office: ______________

_III. Recommendations of Director, Facilities Operations_ :

(Circle One) Approve / Disapprove

Reason for Disapproval: _________________________________________
______________________________________________________________________________
____________________________________________________

__________________________________________________________
Director, Facilities Operations/Designee’s Signature/Date

Retention Schedule: Upon completion, a copy of this form will be placed in the offender’s institutional file.