All questions in section A and B must be answered. If a question does not apply, write Not Applicable on the line.
Section C: ALL questions must be checked YES or NO; if you check YES, you must supply the requested information.
Notification: an e-mail address or self-addressed-stamped envelope when this application is returned will ensure you receive notification of approval or denial to visit.
Without: a self-addressed-stamped envelope or an e-mail address, you will be notified only if your application is denied.
Signed and dated: this form must be legibly signed and dated as indicated in Section D.
Minor: a COPY of the minor's birth certificate, certificate of adoption or court order establishing paternity must be submitted with this application.
| Question | Answer |
|---|---|
| Form Name | CAJ-103 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 158 |
| Avg. time to fill out | 27 min |
| Edition | 02/2025 |
| Where to send | The mail room or information desk of the facility you are requesting to visit |
| Background check | The MDOC uses the information in this application to perform a LEIN background check |
| Other names | CAJ-103, CAJ 103, CAJ103, MDOC Visiting Application, M.D.O.C Visiting Application |
| Official source | CAJ-103 (Rev 02/2025), MDOC |
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