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Corrections referral form

Corrections referral form 2026

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The document is a referral information form for Marion County Community Corrections, aimed at coordinating the county's Criminal Justice Plan to divert non-violent offenders from incarceration while ensuring public safety. It targets adult non-violent felony offenders with sentences of four years or less and Class A misdemeanors. The form requires detailed client and court information, including personal details, charges, court dates, and any relevant treatment history.

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Click ‘Get Form’ to open the corrections referral form in the editor.
Begin by filling out the Client Information section. Enter the Gallery Number, Name, Address, Phone Number, Social Security Number (SSN), City, State, Zip Code, Date of Birth (DOB), Marital Status, FBI Number, Age, Race, Sex, Number of Dependents, Educational Level, and Employment details.
Proceed to the Court Information section. Input the Full Case Number and Reference Source Tx and Fax. Fill in the Charge(s), Reference Source, Charge Class, Next Court Date, Judge's name, and Courtroom number.
In the Plea Agreement/Offer field, provide any relevant details. Indicate if there are other charges pending and explain if necessary.
Complete the Additional Information section by noting if the individual has been in Substance Abuse or Mental Health Treatment and any current health problems.

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