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Please fill out as much information below as you know.

Name of person under conviction:

GDCID # (GDOC Inmate Number):

EF or ZX # (Parole Board Inmate Number):

Name of current institution if incarcerated:

Name of current county of supervision if not incarcerated:

Offense(s) for which convicted:

Approximate date(s) upon which offense(s) occurred:

County of conviction:

Date of conviction:

If you know, name of sentencing judge:

If you know, name of prosecutor:

Name of defense attorney(s) who have represented the person for this criminal matter:

Was the case resolved with a guilty plea or, instead, by going to trial?

What is/was the statutory Parole Eligibility Date "PED" if this is a determinate sentence case for a paroleable sentence/initial consideration date if this if a paroleable life sentence case? If you don't know, you may call and ask the Parole Board at (404) 656-5651.

If the Parole Board has reviewed the case, what was the parole decision (Tentative Parole Month "TPM" for determinate sentences or next scheduled reconsideration date for lifers)? If you don't know, you may call and ask the Parole Board at (404) 656-5651.

Briefly tell us about the reason for you seeking legal help:

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