Department of Justice Rules

BP-A0629 A R

VISITOR INFORMATION U.S. DEPARTMENT OF JUSTICE
Addressee Institution

CDFRM

FEDERAL BUREAU OF PRISONS
Date

Re: (Inmate’s Name and Register No.)

Dear

:

I am requesting that you be included among my approved visitors. In order to establish your suitability as a visitor, it may be necessary for institution officials to send an inquiry to an appropriate law enforcement or crime information agency to ascertain whether or not placing you on my visiting list would present a management problem for the institution, or have other possible adverse effects. The information obtained will be used to determine your acceptability as a visitor. The Bureau of Prisons’ authority to request background information on proposed visitors is contained in Title 18 U.S.C. § 4042. In order for you to be considered for the visiting privilege with me, it will be necessary for you to fill out the questionnaire and release form below and return it to the following address: (Institution address). You are not required to supply the information requested. However, if you do not furnish the information, the processing of your request will be suspended, and you will receive no further consideration. If you furnish only part of the information required, the processing of your request may be significantly delayed. If the information withheld is found to be essential to the processing of your request, you will be informed, and your request will receive no further consideration unless you supply the missing information. Although no penalties are authorized if you do not supply the information requested, failure to supply such information could result in your not being considered for admittance as a visitor. The criminal penalty for making false statements is a fine of not more than $250,000 or imprisonment for not more than five years or both (See 18 U.S.C. § 1001). Sincerely, 1. Legal Name 4. Telephone Number (Including Area Code) 6. Are you a U.S. Citizen? Yes No 2.