FORMS 21 Complete
FORMS 21 Complete
FORM
21
PAROLE/EXECUTIVE
CLEMENCY
CASELOAD
PAROLE
AND
PROBATION
ADMINISTRATION
______________________
Parole
and
Probation
Office
Month
of
_____________
20____
CASELOAD
SUMMARY
NUMBER
I.
INVESTIGATION
CASELOAD
A.
Total
Carry
Over
Investigation
Caseload
B.
Total
Investigation
Referrals
Received
1.
From
Penal
Colonies
2.
From
Prisons
3.
From
Jails
C.
Total
Investigation
Cases
Handled
D.
Total
Investigation
Referrals
Acted
Upon
1.
Reports
Submitted
to
Board
a.
Pre-Parole/Executive
Clemency
Investigation
Report
1.
For
Parole
a.
Grant
b.
Denial
2.
For
Commutation
of
Sentence
a.
Grant
b.
Denial
3.
For
Conditional
Pardon
a.
Grant
b.
Denial
4.
For
Absolute
Pardon
a.
Grant
b.
Denial
2.
Investigation
Cases
Transferred
to
other
PPOs
E.
Total
Active
Pre-Parole/Executive
Clemency
Investigation
Caseload
II.
BOARD
RESOLUTION
OF
INVESTIGATION
CASES
A.
Total
Carry
Over
Cases
Pending
Resolution
by
the
Board
B.
Total
Reports
Submitted
to
the
Board
1.
Pre-Parole/Executive
Clemency
Investigation
Report
a.
For
Parole
b.
For
Commutation
of
Sentence
c.
For
Conditional
Pardon
d.
For
Absolute
Pardon
C.
Total
Cases
to
be
Acted
Upon
by
the
Board
D.
Total
Cases
Resolved
by
the
Board
1.
Granted
a.
Parole
b.
Commutation
of
Sentence
c.
Conditional
Pardon
d.
Absolute
Pardon
2.
Denied
a.
Parole
b.
Commutation
of
Sentence
c.
Conditional
Pardon
d.
Absolute
Pardon
3.
Cancellation
a.
For
Parole
b.
Conditional
Pardon
c.
Commutation
of
Sentence
4.
Died
E.
Total
Cases
Pending
Resolution
by
the
Board
III.
COURTESY
PRE-PAROLE/EXECUTIVECLEMENCY
INVESTIGATION
CASELOAD
A.
Total
Carry
Over
Courtesy
Investigation
Caseload
B.
Total
Courtesy
Investigation
Referrals
Received
C.
Total
Courtesy
Investigation
Cases
Handled
D.
Total
Courtesy
Investigation
Referrals
Completed
and
Returned
E.
Total
Active
Courtesy
Investigation
Caseload
IV.
SUPERVISION
CASELOAD
A.
Total
Carry
Over
Supervision
Caseload
1.
Parolee
2.
Pardonee
B.
Total
Supervision
Referrals
Received
1.
From
Board
of
Pardons
and
Parole
a.
Parolee
b.
Pardonee
2.
Transferred
from
other
PPOs
a.
Parolee
b.
Pardonee
C.
Total
Supervision
Cases
Handled
1.
Parolee
2.
Pardonee
D.
Total
Supervision
Cases
Dropped
1.
Final
Release
and
Discharge
a.
Parolee
b.
Pardonee
2.
Arrest/Recommitment
a.
Parolee
b.
Pardonee
3.
Death
a.
Parolee
b.
Pardonee
4.
Transferred
to
other
PPOs
a.
Parolee
b.
Pardonee
E.
Total
Supervision
Cases
Acted
Upon
by
the
PPO
1.
Reports/Recommendations
Submitted
to
the
Board
a.
Summary
Report
1.
Parolee
2.
Pardonee
b.
Infraction
Report
1.
Parolee
2.
Pardonee
c.
Death
1.
Parolee
2.
Pardonee
2.
Reports
Submitted
to
the
Regional
Director
a.
Transfer
to
other
PPOs
1.
Parolee
2.
Pardonee
F.
Total
Active
Supervision
Caseload
1.
Parolee
2.
Pardonee
V.
BOARD
RESOLUTION
OF
SUPERVISION
CASES
A.
Total
Carry
Over
Cases
Pending
Resolution
by
the
Board
1.
Parolee
2.
Pardonee
B.
Total
Reports/Recommendations
Submitted
to
the
Board
1.
Summary
Report
a.
Parolee
b.
Pardonee
2.
Infraction
Report
a.
Parolee
b.
Pardonee
3.
Death
a.
Parolee
b.
Pardonee
C.
Total
Cases
to
be
Acted
Upon
by
the
Board
1.
Parolee
2.
Pardonee
D.
Total
Cases
Resolved
by
the
Board
1.
Final
Release
and
Discharge
a.
Parolee
b.
Pardonee
2.
Arrest/Recommitment
a.
Parolee
b.
Pardonee
3.
Death
a.
Parolee
b.
Pardonee
E.
Total
Cases
Pending
Resolution
by
the
Board
1.
Parolee
2.
Pardonee
VI.
REGIONAL
DIRECTORS
RESOLUTION
OF
SUPERVISION
CASES
A.
Total
Carry
Over
Cases
Pending
Resolution
by
the
Regional
Director
1.
Parolee
2.
Pardonee
B.
Total
Reports
Submitted
to
the
Regional
Director
1.
Transfer
a.
Parolee
b.
Pardonee
C.
Total
Cases
to
be
Acted
Upon
by
the
Regional
Director
1.
Parolee
2.
Pardonee
D.
Total
Cases
Resolved
by
the
Regional
Director
1.
Transfer
a.
Parolee
b.
Pardonee
E.
Total
Cases
Pending
Resolution
by
the
Regional
Director
1.
Parolee
2.
Pardonee
VII.
COURTESY
SUPERVISION
CASELOAD
A.
Total
Carry
Over
Courtesy
Supervision
Caseload
1.
Parolee
2.
Pardonee
B.
Total
Courtesy
Supervision
Referrals
Received
1.
Parolee
2.
Pardonee
C.
Total
Courtesy
Supervision
Cases
Handled
1.
Parolee
2.
Pardonee
D.
Total
Courtesy
Supervision
Referrals
Terminated
1.
Parolee
2.
Pardonee
E.
Total
Active
Courtesy
Supervision
Caseload
1.
Parolee
2.
Pardonee
FORM
21
TABLE
1
CARRY
OVER
PRE-PAROLE/EXECUTIVE
CLEMENCY
INVESTIGATION
CASELOAD
DOCKET
NO.
PETITIONERS
NAME
DATE
RECEIVED
BY
THE
PPO
INVESTIGATING
OFFICER
FORM
21
TABLE
2
PRE-PAROLE/EXECUTIVE
CLEMENCY
INVESTIGATION
REFERRALS
RECEIVED
AND
ACTED
UPON
REFERRALS
RECEIVED
REFERRALS
ACTED
UPON
DOCKET
PETITIONERS
CC
NAME
OF
OFFENSE
DATE
INVESITGATING
PETITIONERS
DATE
PRE-PAROLE/EXECUTIVE
PPOS
TRANSFERRED
NO.
NAME
NO.
PRISON/JAIL
RECD.
OFFICER
NAME
CLEMENCY
INVESTIGATION
REPORT
RECOMMENDATION
DATE
TO
SUBMITTED
FORM
21
TABLE
3
CARRY
OVER
PRE-PAROLE/EXECUTIVE
CLEMENCY
INVESTIGATION
CASES
PENDING
RESOLUTION
BY
THE
BOARD
DOCKET
PETITIONERS
DATE
REPORTS
PPOS
RECOMMENDATION
INVESTIGATING
NO.
NAME
SUBTD.
TO
THE
PAROLE
COMMUTATION
OF
SENTENCE
CONDITIONAL
PARDON
ABSOLUTE
PARDON
OFFICER
BOARD
GRANT
DENIAL
GRANT
DENIAL
GRANT
DENIAL
GRANT
DENIAL
FORM
21
TABLE
4
PRE-PAROLE/EXECUTIVE
CLEMENCY
INVESTIGATION
CASES
RESOLVED
BY
THE
BOARD
ORDER
RECEIVED
FROM
THE
BOARD
DOCKET
PETITIONERS
GRANTED
DENIED
CANCELLATION
DIED
NO.
NAME
Parole
Commutation
of
Conditional
Absolute
Parole
Commutation
of
Conditional
Absolute
Parole
Commutation
of
Conditional
Sentence
Pardon
Pardon
Sentence
Pardon
Pardon
Sentence
Pardon
FORM
21
TABLE
5
CARRY
OVER
COURTESY
PRE-PAROLE/EXECUTIVE
CLEMENCY
INVESTIGATION
REFERRALS
RECEIVED
DOCKET
NO.
PETITIONERS
NAME
REFERRING
OFFICE
DATE
RECEIVED
BY
INVESTIGATING
REASONS
FOR
REFERRAL
THE
PPO
OFFICER
FORM
21
TABLE
6
NEW
COURTESY
PRE-PAROLE/EXECUTIVE
CLEMENCY
INVESTIGATION
REFERRALS
RECEIVED
AND
COMPLETED
AND
RETURNED
COURTESY
REFERRALS
RECEIVED
COURTESY
REFERRALS
COMPLETED
AND
RETURNED
DOCKET
NO.
PETITIONERS
NAME
REFERRRING
DATE
REASONS
FOR
INVESTIGATING
PETITIONERS
NAME
DATE
COMPLETED
AND
OFFICE
RECEIVED
REFERRAL
OFFICER
RETURNED
FORM
21
TABLE
7
CARRY
OVER
PAROLE
AND
PARDON
SUPERVISION
CASELOAD
PAROLEES
PARDONEES
Docket
Name
Case
Supervising
Date
Recd.
Supervision
Period
Docket
Name
Case
Supervising
Date
Recd.
Supervision
Period
No.
Classification
Officer
by
the
PPO
Starts
Ends
No.
Classification
Officer
by
the
PPO
Starts
Ends
FORM
21
TABLE
8
PAROLE
AND
PARDON
SUPERVISION
REFERRALS
RECEIVED
PAROLEE
PARDONEE
Docket
Name
Type
of
Date
Recd.
Case
Supervising
Supv.
Period
Docket
Name
Type
of
Date
Recd.
Case
Supervising
Supv.
Period
No.
Referral
by
the
PPO
Classification
Officer
Starts
Ends
No.
Referral
by
the
PPO
Classification
Officer
Starts
Ends
FORM
21
TABLE
9
PAROLE
AND
PARDON
SUPERVISION
CASES
ACTED
UPON
PAROLEE
PARDONEE
Docket
Name
Date
Report
Subtd.
to
the
Board
Date
Report
Subtd.
Docket
Name
Date
Report
Subtd.
to
the
Board
Date
Report
Subtd.
to
No.
Summary
Infraction
Death
to
Regional
Director
for
No.
Summary
Infraction
Death
the
Regional
Director
for
transfer
to
other
PPOs
transfer
to
other
PPOs
FORM
21
TABLE
10
CARRY
OVER
PAROLE
AND
PARDON
SUPERVISION
CASES
PENDING
RESOLUTION
BY
THE
BOARD
PAROLEE
PARDONEE
Docket
Name
Date
Report
Subtd.
to
the
Board
Supervising
Docket
Name
Date
Report
Subtd.
to
the
Board
Supervising
No.
Summary
Infraction
Death
Officer
No.
Summary
Infraction
Death
Officer
FORM
21
TABLE
11
PAROLE
AND
PARDON
SUPERVISION
CASES
RESOLVED
BY
THE
BOARD
PAROLEE
PARDONEE
Docket
Name
Dates
Resolution
Recd.
from
the
Board
Docket
Name
Dates
Resolution
Recd.
from
the
Board
No.
Final
Release
and
Arrest/
Death
No.
Final
Release
and
Arrest/
Death
Discharge
Recommitment
Discharge
Recommitment
FORM
21
TABLE
12
CARRY
OVER
PAROLE
AND
PARDON
SUPERVISION
CASES
PENDING
RESOLUTION
BY
THE
REGIONAL
DIRECTOR
PAROLEE
PARDONEE
Docket
Name
Date
Report
Subtd.
Supervising
Docket
Name
Date
Report
Subtd.
Supervising
No.
to
the
Regional
Director
Officer
No.
to
the
Regional
Director
Officer
FORM
21
TABLE
13
PAROLE
AND
PARDON
SUPVERVISION
CASES
RESOLVED
BY
THE
REGIONAL
DIRECTOR
PAROLEE
PARDONEE
Docket
No.
Name
Date
Resolution
Recd.
from
the
Docket
No.
Name
Date
Resolution
Recd.
from
the
Regional
Director
re:
Transfer
Regional
Director
re:
Transfer
FORM
21
TABLE
14
CARRY
OVER
COURTESY
PAROLE
AND
PARDON
SUPERVISION
REFERRALS
RECEIVED
PAROLEE
PARDONEE
Docket
Name
Referring
Date
Recd.
Supervising
Reasons
Case
Docket
Name
Referring
Date
Recd.
Supervising
Reasons
Case
No.
Office
by
the
PPO
Officer
for
Classification
No.
Office
by
the
PPO
Officer
for
Classification
Referrals
Referral
FORM
21
TABLE
15
NEW
COURTESY
PAROLE
AND
PARDON
SUPVERVISION
REFERRALS
RECEIVED
AND
TERMINATED
PAROLEE
PARDONEE
Courtesy
Referrals
Received
Courtesy
Referrals
Courtesy
Referrals
Received
Courtesy
Referrals
Terminated
Terminated
Docket
Name
Referring
Supervising
Period
of
Date
Case
Name
Date
Docket
Name
Referring
Supervising
Period
of
Date
Case
Name
Date
No.
Office
Officer
Courtesy
Recd.
Classi-
Returned
No.
Office
Officer
Courtesy
Recd.
Classifi- Returned
Supv.
fication
Supv.
cation