SOP_NUMBER: 406.19-att-5
TITLE: JPAY Release Card Request Form
DIVISION: Administrative & Finance
TOPIC_AREA: 406 Policy-Administration and Finance
EFFECTIVE_DATE: 2020-07-01
WORD_COUNT: 434
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/338264
URL: https://gps.press/sop-data/406.19-att-5/
SUMMARY:
This form is used by GDC facilities to request JPay release cards for offenders who are being released and will have funds and/or receive Release Gratuity Funds. Facilities must submit the completed form to the Consolidated Banking Unit with offender information including GDC number, name, RPID, release date, and gratuity status. The form must be submitted timely prior to the release date and can be faxed or emailed to the CBU.
KEY_TOPICS: release card, JPay, release gratuity, offender funds, release procedure, banking, inmate money, release card request, offender release, gratuity funds, banking unit
ATTACHMENTS:
1. Offender Miscellaneous Withdrawal Form
URL: https://gps.press/sop-data/406.19-att-1/
2. Request for Indigent Postage
URL: https://gps.press/sop-data/406.19-att-2/
3. Indigent Legal Supplies Request Form
URL: https://gps.press/sop-data/406.19-att-3/
4. Indigent Non-Legal Supplies Request Form
URL: https://gps.press/sop-data/406.19-att-4/
5. JPAY Release Card Request Form
URL: https://gps.press/sop-data/406.19-att-5/
6. JPAY Release Card Receipt Confirmation Form
URL: https://gps.press/sop-data/406.19-att-6/
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FULL TEXT:
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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.