Mississippi  Department of  Corrections

Christopher B. Epps  

Haley R. Barbour

Commissioner   

 Governor  

 

 

 

Victims Notification Form

 

Mississippi Department of Corrections Victims Notification

 

 

(PLEASE DO NOT COMPLETE THIS NOTIFICATION REQUEST FORM UNLESS YOU ARE A VICTIM OF CRIME, A SURVIVOR OF A HOMICIDE  VICTIM, OR A WITNESS TO A CRIME)

As a victim of crime, you have the right to be notified within fifteen (15) days prior to the end of the sentence of the prisoner, notice of release upon expiration of sentence or notice of medical release, and notice within fifteen (15) days after the prisoner has died (if within the custody of the Mississippi Department of Corrections). You also have the right to be notified of any escape and subsequent recapture of the offender.  Other Victim Rights afforded under the authority of Mississippi Department of Corrections include:

 

  •  Right to submit an audio or video recording to be placed in offenders file for consideration of community status or prior to release

 

  • Right to be notified and allowed to submit a written or recorded statement when parole or pardon is considered

 

  • Right to be notified if the offender is released on an appeal bond

  Crime Victims Notification Form

 
  1. Name of Offender
     
  2. Relationship to victim: 
  3. Offender MDOC Number
     
  4. County of Conviction and Crime (County; Crime)

      
     

  5. Enter the date of  Sentencing

      -- mm/dd/yy

     

    *Please enter YOUR (The victim requesting the information) name and address.*

     

  6. Enter E-Mail Address

     
     

     

  7. Address          
Name  
Street Address  
Address (cont.)
City  
State/Province  
Zip/Postal Code
Country
  1. Phone Numbers
    Work Phone
    Home Phone

    Cell Phone

Please feel free to complete a Victim Impact Statement

To be notified by the Mississippi Department of Corrections of these changes in the offender’s status, you must complete this form and return it to:

Mississippi Department of Corrections

Division of Victim Services

723 North President Street

Jackson, MS 39202

1-866-522-4087 (toll free)

601-359-5628

Fax: 601-359-5719

Please be advised that if the offender is in custody in a local jail,

you must contact the jail directly for notification.

 

Message to Crime Victims:

For timely offender notification, be sure to contact the Division of Victim Services of 

any changes in your address or telephone number.

MDOC Webmaster.
Copyright © 1999 Mississippi Department of Corrections. All rights reserved.
Revised: January 19, 2010