Form Cdcr 1707 - Request For Victim Services Form Page 2
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1
2STATE OF CALIFORNIA
DEPARTMENT OF CORRECTIONS AND REHABILITATION
REQUEST FOR VICTIM SERVICES
CDCR 1707 (Rev. 04/08 Internet)
I
N S T R U C T I O N S
Read the following instructions carefully to fill out the form so that it can be processed correctly.
Check one of the two boxes at the top of the CDCR 1707 form to indicate if this is a new/revised request or a change of
address only. If you check the “Change of address only” box, complete sections A, E, and F only.
S
A. A
I
S
C. C
P
I
ECTION
PPLICANT
NFORMATION
ECTION
ONDITIONS OF
AROLE FOR
NMATE
Check the box that most accurately describes your
Special conditions of parole are not guaranteed but you
relationship to the inmate: victim, witness, concerned
may check all that you wish to request.
citizen, or family member of victim (next of kin)--indicate
relationship to victim.
Checking the 1st box will request that the parolee have no
contact with you while he/she is on parole.
Circle the appropriate title: Mr., Mrs., or Ms.
Clearly print your name, home address, mailing address (if
Checking the 2nd box will request that the parolee not be
different), telephone number where you can be reached
allowed to live in the same county that you live in.
during the day, and email address (if you have one).
The third box applies to victims and witnesses only.
Checking the 3rd box will request that the parolee not be
N
: It is your responsibility to keep the OVSRS informed
OTE
of any changes to your personal information.
allowed to live within 35 miles of your home address.
Per Penal Code Section 3003, available only for the
following:
murder or voluntary manslaughter, mayhem,
S
B. N
I
S
P
ECTION
OTIFICATION OF
NMATE
TATUS IN
RISON
Check the most appropriate box(es) regarding your
rape, sodomy by force, oral copulation, lewd acts on a
request.
child under 14, any felony punishable by death, stalking,
and assault with a great bodily injury enhancement.
Checking the 1st box will register you for notification of the
release, escape, or death of an inmate.
S
D. R
ECTION
ESTITUTION
Restitution is only collected if it is court ordered by a judge.
Checking the 2nd box will allow the Office of Victim and
Completing this section will provide the OVSRS with
Survivor Rights and Services (OVSRS) to share your
information to verify that our restitution records are
information with the California Attorney General’s Office.
complete. If your direct order of restitution states “TBD” for
The Attorney General’s Office will notify you of the status
the dollar amount, contact the district attorney’s office to
and outcome of any criminal appeal filed by the inmate in
request that a motion be filed to determine the restitution
this case.
amount.
The third box applies to victims/next of kin only.
S
E. I
I
ECTION
NMATE
DENTIFICATION
Checking the 3rd box will register you for notification of
Provide as much information as you can in this section so
the date of an inmate’s parole hearing only if the inmate
we can be sure that we have the correct inmate involved in
has been sentenced to a prison term with a life sentence.
your case. If you need help completing this section, you
may contact the District Attorney’s Office in the county
In addition, check yes to allow the OVSRS to share your
where the trial was held.
information with the district attorney’s office where the trial
was held. The district attorney’s office will help you if there
S
F. A
S
ECTION
PPLICANT
IGNATURE
is a parole hearing for an inmate with a life sentence.
You must sign and date the form. The form cannot be
Check no if you do not want us to share your information.
processed without a signature. Forms without a signature
will be returned.
:
E E P T H E P I N K C O P Y F O R Y O U R R E C O R D S A N D M A I L T H E W H I T E O R I G I N A L A N D Y E L L O W C O P Y T O
MAIL COMPLETED FORM TO :
Office of Victim and Survivor Rights and Services
P.O. Box 942883
Sacramento, CA 94283-0001
PRIVACY STATEMENT:
AGENCY STATEMENT: The California Department of Corrections & Rehabilitation (CDCR), Request for Victim Services, CDCR 1707.
OFFICE RESPONSIBLE FOR FORM: Office of Victim and Survivor Rights and Services, P.O. Box 942883, Sacramento, CA 94283-
0001. The telephone number is 1 (877) 256-6877. AUTHORITY: Penal Code Section 679.003, 2085.5, and 3058.8.
PROVIDING INFORMATION: The information requested is necessary to process your request for victim services and is voluntary.
Failure to provide any of the information requested may prevent OVSRS from processing your request. All information will remain
confidential.
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