SOP 221.03-att-1: Replacement I.D. Request Form
Summary
Key Topics
- replacement ID
- offender identification card
- ID request
- replacement fee
- inmate ID
- offender account deduction
- ID card replacement process
- facility identification
Full Text
SOP IIB01-0019
(221.03)
Attachment 1
05/25/22
REPLACEMENT I.D. REQUEST FORM
Date: ___________________
Offender Name: ______________________ Offender I.D.#: _____________________
Offender Location (Bldg./Dorm/Room#): ________________________________________
I, _______________________________, located at _______________________S.P. request a
replacement I.D. card for the following reason(s): ____________________________________
_______________________________________________________________________________
_______________________________________________________________________________
I agree to have five ($5.00) dollars deducted from my Consolidated Banking Unit account for the
reissuance of my Offender ID card. I further agree that if I am indigent, or have insufficient funds
to cover this cost, that my account will be debited and any monies received will be deducted until
the five ($5.00) dollars is recovered, in full, by the facility.
Offender Signature and State I.D. #:
Request Approved: _____________________ Request Disapproved: _______________________
Warden/Superintendent or Designee
Signature: ________________________________________Date:___________________________
After careful review of this request, I have determined that the Replacement fee of five ($5.00) will
be waived for the following reason(s):_________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Warden/Superintendent/Designee: _________________________Date:______________________
RETENTION SCHEDULE: Upon completion, this form shall be forwarded to the business office and kept there for
three years beyond the date of an internal audit, then destroyed.