Application For Absolute Discharge From Parole - Arizona Board Of Executive Clemency Page 3
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8Describe your behavior while on parole that demonstrates that you are a law abiding citizen, a
contributor to the community and are no longer a risk to others.
1. Date of Parole Grant: ____________________ Date Released: ___________________
2. If any, sentence expiration date: ______________________________
3. Was restitution imposed on sentence(s)?
(circle one) Yes
No
4. If so, what was the order amount?
$ _________________ per ___________________
5. In order to receive Absolute Discharge, restitution must be paid in full. Is your
court-ordered restitution been satisfied with the court? (circle one) Yes
No
PRIOR CONVICTIONS
Offense(s)
Cause
State/County
Sentence
Number
pg. 3
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