Inmate to Inmate Funds Transfer Request Form

IDAHO DEPARTMENT OF CORRECTION
Inmate-to-Inmate Funds Transfer Request Form
Transferring Inmate's Information
Name: IDOC #:
Last, First, Middle
Facility:
The immediate family relationship to the recipient inmate is:
❑ Parent ❑ Sibling ❑ Spouse ❑ Child ❑ Grandparent ❑ Grandchild
Type of transfer: ❑ One-time ❑ On-going Amount:
Signature Date
Note: You must fill out an Inmate Personal Funds Withdrawal Slip each time you wish to
transfer funds to your immediate family member. The Inmate Personal Funds Withdrawal
Slip must be completely and correctly filled out and signed by your facility staff member, even
if you already have a signed approval form on file. If the Inmate Personal Funds Withdrawal
Slip is not filled out correctly, it will be returned to you unprocessed.
Recipient Inmate's Information
Name: IDOC #:
Last, First, Middle
Facility:
Facility Heads' Approval
Transferring Inmate's facility head or designee
The requested transfer of funds is: ❑ Approved ❑ Not Approved
Signature Date
Recipient Inmate's facility head or designee
The requested transfer of funds is: ❑ Approved ❑ Not Approved
Signature Date
114.03.03.024
(Updated 03/15/2017)