SOP 406.19-att-5: JPAY Release Card Request Form
Summary
Key Topics
- release card
- JPay
- release gratuity
- offender funds
- release procedure
- banking
- inmate money
- release card request
- offender release
- gratuity funds
- banking unit
Full Text
SOP 406.19
Attachment 5
7/1/20
|Release Card Request Form|Col2|Col3|Col4|Col5|Col6|Col7|
|---|---|---|---|---|---|---|
|Please complete this form and submit to the Cons. Banking Unit for all instances of release that will have
funds and/or will be receiving Release Gratuities Funds. Please do not include offenders that will not
receive a release card.|Please complete this form and submit to the Cons. Banking Unit for all instances of release that will have
funds and/or will be receiving Release Gratuities Funds. Please do not include offenders that will not
receive a release card.|Please complete this form and submit to the Cons. Banking Unit for all instances of release that will have
funds and/or will be receiving Release Gratuities Funds. Please do not include offenders that will not
receive a release card.|Please complete this form and submit to the Cons. Banking Unit for all instances of release that will have
funds and/or will be receiving Release Gratuities Funds. Please do not include offenders that will not
receive a release card.|Please complete this form and submit to the Cons. Banking Unit for all instances of release that will have
funds and/or will be receiving Release Gratuities Funds. Please do not include offenders that will not
receive a release card.|Please complete this form and submit to the Cons. Banking Unit for all instances of release that will have
funds and/or will be receiving Release Gratuities Funds. Please do not include offenders that will not
receive a release card.|Please complete this form and submit to the Cons. Banking Unit for all instances of release that will have
funds and/or will be receiving Release Gratuities Funds. Please do not include offenders that will not
receive a release card.|
|FACILITY :|FACILITY :||||||
|CONTACT
PERSON:|CONTACT
PERSON:||||||
|DATES OF
RELEASES:|DATES OF
RELEASES:||||||
|(ALL FIELDS MUST BE COMPLETED WHEN SUBMITTED)|(ALL FIELDS MUST BE COMPLETED WHEN SUBMITTED)|(ALL FIELDS MUST BE COMPLETED WHEN SUBMITTED)|(ALL FIELDS MUST BE COMPLETED WHEN SUBMITTED)|(ALL FIELDS MUST BE COMPLETED WHEN SUBMITTED)|(ALL FIELDS MUST BE COMPLETED WHEN SUBMITTED)|(ALL FIELDS MUST BE COMPLETED WHEN SUBMITTED)|
|Release
Date|
GDC#|
GDC#|Offender
Last Name|Offender
First Name|
RPID#|
Gratuity(y or n)|
|Example:
01/01/2012|Example:
1234567|Example:
1234567|Example:
Smith|Example:
John|Example:
123456|Example:
Y|
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Please fax to Consolidated Banking Unit (CBU) @ 478-992-6317. This form can also be scanned and emailed
to “OFFENDERPAYMENTS@dcor.state.ga.us”. All releases should be submitted timely and will be processed by release
date. In the event of an unexpected release, notify your CBU contact person.
Retention Schedule: Upon completion, this form shall be scanned and maintained electronically for five (5) years on
the CBU server.