Executive Clemency Application Form – Fill Out and Use This PDF

The Executive Clemency Application form serves as a critical document for individuals seeking clemency in the state of Arkansas. It is a formal request to the Governor for a pardon, commutation of sentence, or restoration of firearms rights, necessitating meticulous completion in either blue or black ink. Filled with sections that ask for comprehensive personal background, criminal history, reasons for the clemency request, and supporting documentation, the form is a pivotal step for applicants to state their case for consideration. To start the process of applying for executive clemency, click the button below.

Get Form Now Download PDF

Executive Clemency Application Form PDF Details

The Executive Clemency Application form, provided by the Office of the Governor of Arkansas, represents a critical pathway for those seeking a form of legal mercy or reprieve from the state. Candidates are instructed to use either blue or black ink to detail personal information, reasons for applying, and to specify the type of clemency sought: commutation, pardon, or firearm restoration. The application process requires a comprehensive revelation of one's criminal history, personal background, and a thorough explanation of why clemency is being requested, including any injustices felt during trial, exceptional institutional behavior, or severe medical conditions that may warrant a reduction in sentence or a restoration of rights. Supporting documents play an essential role in substantiating these claims. Applicants are also made aware that their request might not be considered if there are pending appeals or petitions for post-conviction relief. The application further prompts disclosure of marital status, children, educational background, and employment history, thereby painting a holistic picture of the applicant's life and circumstances for the reviewing board. This form embodies the hope of many for a second chance or recognition of reformation, reflecting the gravity and complexity of navigating the executive clemency process.

Question	Answer
Form Name	Executive Clemency Application Form
Form Length	7 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 45 sec
Other names	arkansas clemency, arkansas clemency form, board arkansas gov executive clemency applications, ar clemency

Form Preview Example

STATE OF ARKANSAS

OFFICE or THE GOVERNOR

Mike Huckabee

Governor

EXECUTIVE CLEMENCY APPLICATION

Please use blue or black ink when completing the application.

Name:___________________________________	Date of Birth______________
City_________________________________________	ADC or DCP #:_____________
	(If applicable)


State:	Zip:_______ Social Security #_______________
Telephone (home):		(work):________________________

***************************************************************************

Person preparing the application (if other than yourself)

Name:_____________________________________________________________________

Address:____________________________________________________________________

City______________________________ State________________________ Zip________

Telephone (home):(work)______________________________

**************************************************************************

I AM APPLYING FOR.,

COMMUTATION (time cut) (Please continue on Page 2)

PARDON (Please continue on Page 3)

FIREARM RESTORATION ONLY (Please continue on Page 3)

State Capitol Building Suite 250 * Little Rock, AR 72201 *

mike.huckabee@state.ar.us

My reason(s) for applying for a commutation of my sentence (time cut):

Place an X in the appropriate

below:

1.I wish to correct an in-justice which may have occurred during the trial, I have attached letters or other documentation that will support this claim. If you wish to attach an explanation or statement to this application, it will be considered as a part of the application. Discuss results of appeals or Rule 37 or other post conviction proceedings in an attached statement.

2. I have a life-threatening a medical condition which does not qua i y for Act 290, I have

attached a statement explaining my condition. Your medical statement will be validated by ADC Medical Services before being sent to the Post Prison Transfer Board.

3.I want to adjust what may be considered an excessive sentence.

4.My institutional adjustment has been exemplary and the ends of -justice have been achieved,

NOTE:

A.All supporting documentation must be available when the Board considers your application.

B.The Board will ordinarily not consider your application if your case is currently being appealed or if a Rule 37 petition or other petition of post-conviction relief is pending.

C.If your application is based on your belief that your sentence is excessive or that your institutional adjustment has been exemplary and the ends of justice have been achieved, the application will ordinarily be denied if you have not served the portion of your sentence indicated by the following table:

Life Sentence	12 years
Over 30 years	7 years
25 - 30 years	6 years
22 - 24 years	5 years
19 - 21 years	4 years
16 - 18 years	3 years
11 - 15 years	2 years
Below I I years	1 year

If you believe that this table should not apply in your case, you should attach a statement of your reasons to this application.

1Give the full name under which you were convicted and any alias names you have used:

_______________________________________________________________________

2.List all crime(s) for which you have been convicted, the county of conviction, date of conviction, docket number, and sentence. (Sentence may include fines, probation*, suspended sentence or time incarcerated in then Arkansas Department of Correction or the Department of Community Punishment.)

Crime(s)

County

Conviction Date	Docket #

Sentence

NOTE: Please attach a separate sheet if necessary to include all offenses.

*Please include a copy of any orders of probation or suspended sentence you may have received.

3,	Are you currently:
	serving a sentence in the ADC or DCP?	Discharge date:________________
	on parole?	Discharge date:_______________
	on probation?	Discharge date:________________
	serving a suspended sentence?		Discharge
	date:_______________________	discharged from your sentence
	Discharge date:_______________________
4.	Are you requesting the restoration of your right to own and possess firearms?			Yes	No
5.	Were other person also involved in the crime?	Yes	No

If yes, list the names of your accomplices and what, if any, sentences they received.

____________________________________________________________________

_________________________________________________________________________________

6.Concerning the facts of the crime, briefly explain what happened.

____________________________________________________________________

7.What is your reason for requesting executive clemency at this time?

_________________________________________________________________________________

__________________________________________________________________________________

CRIMINAL HISTORY

List all juvenile, misdemeanor, DWI traffic violations, etc, or crimes committed outside the state of Arkansas. Do not include convictions fisted in response to question 2 above.

Crime(s)

County/State

Conviction Date

Docket #

Sentence

PERSONAL BACKGROUND:
I	Are you:	Single	Married	Separated Divorced Widowed

If married, what is your spouse's full name?_________________________________

When and where were you married?______________________________________

2.For any previous marriages, List the following information:


	Name of Spouse	Date of Marriage	Date Marriage Ended		Reason (divorce, death etc.)
	_______________________________________________________________________________________________
	_______________________________________________________________________________________________
	_______________________________________________________________________________________________
3.	How many children do you have?,			List the following information:
	Name	Age		Address

________________________________________________________________________

.	Have you ever served in the Armed Forces?	Yes	No
	If so, which branch?____________________________________________________________________
	What type of discharge did you receive?	Honorable	Dishonorable	Medical	Other

DUCATIONAL BACKGROUND:

List the following information about all schools you have attended, including any vocational-technical training:

Name & Address of SchoolDate of Attendance Highest Grade Completed/Degree

_______________________________________________________________________________________________

______________________________________________________________________________________________

EMPLOYMENT BACKGROUND:

IPlease provide the following information about your current job:

Name of employer:____________________________________________________________

Employer's address:___________________________________________________________

When were you hired:_________________________________________________________

Give a brief description of your job responsibilities:__________________________________

____________________________________________________________________________

2.If you are currently unemployed, but on disability, please list how you became disabled (work-related injury, etc.)________________________________________________________

_____________________________________________________________________________

3.For previous jobs you have held, list the following information:

Name & Address of Employer	Type of work	Dates employed	Reason for Leaving

MISCELLANEOUS INFORMATION:
1	How is your health?	Excellent	Good	Fair	Poor
2.	Have you ever been confined to a mental hospital? Yes			No
	If yes, list the following information:
	Name & Address of Institution		Date committed	Date released

3.	Do you use any type of drugs, including prescription drugs?			Yes No
	If yes, list the type of drugs and the reason for their use:________________________
	_____________________________________________________________________
__________________________________________________________________________________
4.	Do you use alcohol?	Yes	No.
	If yes, how often:	Periodically	Regularly	Socially	Heavily

5.Have you ever received treatment for alcohol or drug problems (example: Alcoholics

Anonymous)? Yes No

If yes, please provide a brief explanation:

REFERENCES
list three (3) people not related to you who have known you for at least five (5) years:
Name	Address/City/State/Zip	Phone

By signing this application, I hereby swear that the information Provided is one and accurate to the best of my knowledge.

Applicant's Signature

Date of application

How to Edit Executive Clemency Application Form Online for Free

Dealing with PDF documents online is certainly surprisingly easy with this PDF tool. You can fill out application for executive clemency here and try out a number of other functions available. To make our editor better and easier to work with, we constantly implement new features, taking into consideration feedback coming from our users. To get the process started, go through these easy steps:

Step 1: Access the PDF doc inside our editor by pressing the "Get Form Button" in the top area of this webpage.

Step 2: Using our advanced PDF editor, you can do more than simply complete forms. Try all of the functions and make your documents look great with custom textual content put in, or modify the original input to perfection - all comes with the capability to incorporate stunning photos and sign it off.

For you to fill out this form, be sure to provide the necessary details in each blank field:

1. When filling in the application for executive clemency, make certain to incorporate all of the necessary fields within its corresponding section. It will help hasten the work, enabling your details to be handled quickly and accurately.

Filling out segment 1 in clemency forms arkansas

2. Right after filling in this step, go to the subsequent part and complete the essential particulars in all these blank fields - City State Zip, Telephone home work, I AM APPLYING FOR, COMMUTATION time cut Please, PARDON, Please continue on Page, FIREARM RESTORATION ONLY Please, State Capitol Building Suite, and mikehuckabeestatearus.

Part number 2 in completing clemency forms arkansas

3. The following segment is mostly about Life Sentence Over years years, years years years years years, and If you believe that this table - complete each one of these fields.

Part no. 3 of completing clemency forms arkansas

4. Filling in Give the full name under which you, List all crimes for which you have, Crimes, County, Conviction Date, Docket, Sentence, NOTE Please attach a separate, and Are you currently serving a is paramount in this fourth form section - be certain to don't hurry and fill in each and every empty field!

Step # 4 in filling in clemency forms arkansas

In terms of Crimes and County, be sure you take a second look here. Both of these are definitely the key fields in this page.

5. The pdf has to be finished by filling in this area. Below there can be found a detailed listing of blank fields that need correct information for your document submission to be accomplished: Are you currently serving a, Discharge date, Are you requesting the restoration, Were other person also involved in, If yes list the names of your, and Concerning the facts of the crime.

Filling in section 5 of clemency forms arkansas

Step 3: Revise all the information you have typed into the blanks and hit the "Done" button. Obtain your application for executive clemency as soon as you sign up for a free trial. Instantly use the form from your FormsPal cabinet, together with any edits and adjustments being conveniently saved! At FormsPal, we strive to guarantee that all your details are stored private.

Executive Clemency Application Form – Fill Out and Use This PDF

Executive Clemency Application Form PDF Details

Form Preview Example

How to Edit Executive Clemency Application Form Online for Free

Executive Clemency Application Form isn’t the one you’re looking for?

Related Documents