Mississippi Clemency Form – Fill Out and Use This PDF

The Mississippi Clemency Form is designed to provide due process and opportunity for qualified offenders whom have completed their time behind bars. It offers a new hope through which individuals can reestablish themselves as responsible members of society. This special permission to pardon shows mercy and compassion in place of actionby the criminal justice system, affording those convicted of select offenses a brand new start at life. The special pardons may include reducing sentences, reinstating civil rights, restoration of probation periods and chance to receive parole even after denial. Not only striving to empower former inmates, this form also serves as great relief for both prisoners and immediate families who asked to navigate through the most traumatizing experiences imaginable.

Mississippi Clemency Form PDF Details

If you are facing conviction in Mississippi, and believe you deserve a second chance at life outside of prison—or even inside it—you may be eligible for clemency. Mississippi’s clemency form grants individuals the opportunity to ask the governor or parole board to consider their current state of affairs and grant them mercy through sentence modifications, revoking convictions all together, or releasing individuals who have completed their sentences early. It is an important right that can help turn lives around, offering individualized relief for qualifying persons who have paid their debt to society or are struggling with systemic injustice within criminal justice systems that treat people differently based on race and social status. In this blog post, we'll explain how to fill out a clemency form in Mississippi so you can make your case for leniency and get back on track towards living your best possible life!

Question	Answer
Form Name	Mississippi Clemency Form
Form Length	6 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 30 sec
Other names	clemency forms jackson mississippi, mississippi clemency form, ms office of gov clemency, mississippi application for executive clemency

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STATE OF MISSISSIPPI

OFFICE OF THE GOVERNOR

APPLICATION FOR CLEMENCY

The applicant MUST complete the application for clemency (use extra paper if necessary.)

CONSIDERATION OF THIS APPLICATION DOES NOT NECESSARILY RESULT IN THE CLEMENCY REQUEST BEING GRANTED.

___ Pardon	___ Commutation of Sentence		___ Restoration of Civil Rights
1. NAME:_________________________________________________________________________________
	Last	First	Middle
2. SOCIAL SECURITY #		3. DATE OF BIRTH_________________________

4.DEPARTMENT OF CORRECTIONS NUMBER:_______________________________________________

5.ADDRESS:______________________________________________________________________________

StreetCity

___________________________________________ 6. PHONE NUMBER:____________________

State	Zip
7. MARITAL STATUS: ____________________		8. SPOUSE'S NAME:___________________________
9. SPOUSE'S ADDRESS: ____________________________________________________________________
	Street	City	State	Zip

10. NAMES AND AGES OF DEPENDENT

CHILDREN:___________________________________________

__________________________________________________________________________________________

11.CRIMINAL CHARGES OR CONVICTIONS (Include ALL past and pending charges regardless of conviction. Include felony(s) and/or misdemeanor(s), excluding traffic violations - use extra paper if necessary):

a)__________________________________________________________________________________

Charge	Conviction Received
____________________________	___________________________________
Date Convicted	County of Court
____________________________	___________________________________
Judge	Prosecutor
____________________________	___________________________________
Defense Attorney	Sentence
____________________________	___________________________________
Period of Incarceration	Place Incarcerated

b)__________________________________________________________________________________

Charge	Conviction Received
____________________________	___________________________________
Date Convicted	County of Court
____________________________	___________________________________
Judge	Prosecutor
____________________________	___________________________________
Defense Attorney	Sentence
____________________________	___________________________________
Period of Incarceration	Place Incarcerated

12. If ever incarcerated, state every instance the applicant received disciplinary action (be specific):

13. Conviction(s) for which the pardon is being sought:_____________________________________________

14. List Applicant's four most recent employers:

1)__________________________________		_________________________________________
Employer's Name		Employer’s Address
_______________________	___________________
______________________________
Supervisor	Period Employed	Reason for Leaving

2)__________________________________		_________________________________________
Employer's Name		Employer’s Address
_______________________	___________________
______________________________
Supervisor	Period Employed	Reason for Leaving

3)__________________________________		_________________________________________
Employer's Name		Employer’s Address
_______________________	___________________
______________________________
Supervisor	Period Employed	Reason for Leaving

4)__________________________________		_________________________________________
Employer's Name		Employer’s Address
_______________________	___________________
______________________________
Supervisor	Period Employed	Reason for Leaving

15.Military record (include branch of military, date of service and type of discharge):

____________________________________________________________________________________

16.Names and addresses of three non-family references:

1)_________________________________________________________________________________

2)__________________________________________________________________________________

3)__________________________________________________________________________________

17.Has the Applicant ever received clemency:____________________

18.Has the Applicant ever been on parole? ____________________ If yes, has the Applicant ever been found in violation of any terms or conditions of the parole?____________________ If yes, explain on extra paper.

19.Has the Applicant ever been on probation? ___________________ If yes, state the name(s) and address(es) of the Applicant's probation officer(s):

__________________________________________________________________________________________

20.Has the Applicant ever been found in violation of any terms or conditions of the probation? _______________ If yes, explain on a separate sheet of paper.

21.In a separate letter, which must accompany this application, state the extenuating circumstances supporting the basis for the clemency request.

22.Letters of recommendation in support of the request for clemency must accompany this application. Letters may be submitted from all sources, including but not limited to the following: neighbors, employers, co-workers, pastors, church members, elected officials, judges, prosecutors, family members, etc....

23.Name, address and phone number of person(s) to contact if we need to contact you on an emergency basis.

I SWEAR OR AFFIRM THAT THE INFORMATION REPORTED IN THIS APPLICATION FOR CLEMENCY AND ANY ACCOMPANYING MATERIAL IS COMPLETE AND ACCURATE.

_________________________	_____________________________________
Date	Signature

COMPLETION OF THE APPLICATION, WHICH MUST BE IN FULL, MEANS ONLY THAT THE APPLICANT MAY BE CONSIDERED FOR CLEMENCY, NOT THAT ONE WILL BE GRANTED.

Promptly notify us concerning any change of address or change in telephone listing.

Return completed Application for Clemency with letter which states the extenuating circumstances supporting the basis for the clemency request to:

Office of the Governor

Attn: Legal Division

PO Box 139

Jackson, MS 39205-0139

How to Edit Mississippi Clemency Form Online for Free

When using the online tool for PDF editing by FormsPal, you may fill out or alter ms application for clemency here and now. The editor is continually maintained by our staff, getting handy features and growing to be greater. Starting is effortless! All you should do is adhere to these simple steps below:

Step 1: Hit the "Get Form" button above. It is going to open up our pdf editor so that you could begin filling in your form.

Step 2: The tool lets you modify PDF documents in various ways. Change it with personalized text, adjust what's already in the file, and put in a signature - all doable in no time!

Concentrate while filling out this form. Ensure all mandatory fields are completed correctly.

1. Complete your ms application for clemency with a selection of major blank fields. Collect all of the necessary information and ensure there is nothing omitted!

ms office of gov clemency conclusion process shown (part 1)

2. Immediately after this part is completed, go on to enter the applicable information in these - SPOUSES ADDRESS, Street, City, State, Zip, and NAMES AND AGES OF DEPENDENT.

ms office of gov clemency writing process outlined (part 2)

3. In this particular stage, check out CRIMINAL CHARGES OR CONVICTIONS, Charge, Conviction Received, Date Convicted, County of Court, Judge, Prosecutor, Defense Attorney, Sentence, Period of Incarceration, Place Incarcerated, Charge, and Conviction Received. Each one of these need to be filled in with utmost accuracy.

Stage # 3 of filling out ms office of gov clemency

4. All set to complete this fourth segment! In this case you will get all of these Date Convicted, County of Court, Judge, Prosecutor, Defense Attorney, Sentence, Period of Incarceration, Place Incarcerated, and If ever incarcerated state every form blanks to fill in.

Part number 4 in submitting ms office of gov clemency

5. This very last step to finalize this PDF form is critical. Be sure to fill in the displayed fields, like , before finalizing. Or else, it can contribute to an unfinished and possibly incorrect paper!

this field, next field, and other fields in ms office of gov clemency

Be extremely careful when filling in this field and next field, since this is the section where a lot of people make errors.

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Mississippi Clemency Form – Fill Out and Use This PDF

Mississippi Clemency Form PDF Details

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