SOP 406.19-att-6: JPAY Release Card Receipt Confirmation Form

Division:
Administrative & Finance
Effective Date:
July 1, 2020
Topic Area:
406 Policy-Administration and Finance
PowerDMS:
View on PowerDMS
Length:
117 words

Summary

This form documents the receipt and activation of a JPay debit release card given to an offender upon scheduled release from a GDC facility. The form captures offender identification information, card activation details, and requires signatures from both business office staff and the releasing offender to confirm receipt of the card and verification of the mailing address. The form must be retained locally for three years after completion.

Key Topics

  • JPay debit card
  • release card
  • offender release
  • debit card activation
  • release processing
  • release card receipt
  • offender discharge
  • business office
  • releasing officer
  • PIN assignment

Full Text

SOP 406.19

Attachment 6
7/1/20
# JPAY RELEASE CARD RECEIPT CONFIRMATION FORM Scheduled Release Date: _________________________________________

RELEASING FACILITY ______________________________________

OFFENDER GDC ID ______________________________________

OFFENDER LAST NAME ______________________________________

OFFENDER FIRST NAME ______________________________________

J PAY CARD R P I D# _______________________________________

OFFENDER’S MAILING ADDRESS _____________________________________________________________________

______________________________________________________________________

DATE DEBIT CARD WAS ACTIVATED ________________________________

______________________________________________________________________
PRINTED NAME OF BUSINESS OFFICE STAFF THAT PROCESSED THE DEBIT CARD

________________________________________________________________ _______________________
SIGNATURE OF BUSINESS OFFICE STAFF THAT PROCESSED THE DEBIT CARD DATE PROCESSED

SIGNATURE OF OFFENDER ______________________________________________ __________________________
I acknowledge that I received my Debit Release Card, and the address provided above is correct DATE
OFFENDER SHOULD CALL NUMBER ENCLOSED TO ASSIGN DEBIT CARD PIN NUMBER***

_______________________________________________________
PRINTED NAME OF RELEASING OFFICER

______________________________________________________
SIGNATURE OF RELEASING OFFICER

Retention Schedule: Upon completion, this form shall be retained locally for three (3) years and then destroyed.

Attachments (6)

  1. Offender Miscellaneous Withdrawal Form (199 words)
  2. Request for Indigent Postage (127 words)
  3. Indigent Legal Supplies Request Form (197 words)
  4. Indigent Non-Legal Supplies Request Form (144 words)
  5. JPAY Release Card Request Form (434 words)
  6. JPAY Release Card Receipt Confirmation Form (117 words)
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