Get Wy Application For Restoration Of Voting Rights 2018-2024

STATE OF WYOMING BOARD OF PAROLE Application For Restoration Of Voting Rights To Non-Violent Offenders NOTE Pursuant to W*S* 7-13-105 the Board of Parole may only restore voting rights to individuals meeting the following criteria 1 There must have been only ONE prior felony or more than one arising out of the same occurrence 2 The felony s must NOT have been VIOLENT as defined by W*S* 6-1-104 a xii and 3 Five years must have elapsed since completion of the sentence including any probation or parole period. 1. Name DOB SS 2. Name Convicted Under 3. Address 4. City State/Zip Phone 5. Crime Date of Conviction 6. Sentencing Court Sentence Imposed 7. Was the Sentence Suspended Yes No 8. Date of Probation Date of Discharge 9. County of Conviction State of Conviction 10. Date Imprisoned Date Released 11. Date of Parole Date of Discharge 12. States resided in since expiration of above conviction 13. List other convictions if any VIOLENT CRIMES include murder manslaughter kidnapping sexual assault in the first or second degree robbery aggravated assault aircraft hijacking arson in the first or second degree aggravated burglary sexual abuse of a minor in the first or second degree if an actor sixteen 16 years or older committed sexual intrusion on a victim less than thirteen 13 years of age. 14. A CERTIFIED COPY of the JUDGEMENT AND SENTENCE and DISCHARGE ORDER from probation MUST BE ATTACHED TO THIS APPLICATION* A copy may be obtained from the Clerk of the Court where you were convicted* 15. Information showing the date of EXPIRATION OF SENTENCE or COMPLETION OF PAROLE MUST BE ATTACHED TO THIS APPLICATION* This information Wyoming Women s Center or from staff at the Central Office of the Wyoming Department of Corrections or similar authorities in other states or the federal government if it is not a Wyoming sentence. 16. Submission of this signed and notarized application INCLUDING requested documents authorizes the Board of Parole to perform a criminal history check. I hereby certify under penalty of false swearing a felony under W*S* 1-2-104 the above information to be true and that I have not been convicted of any other felony not listed above and that the above felony is not a violent crime as defined herein* I further certify under penalty of false swearing a felony under W*S* 1-2-104 that all my terms of sentence are expired and I have completed all periods of probation or parole and that at least five 5 years have passed since all terms of my sentence expired and/or since I completed any period of probation or parole. Date Signed Applicant State of ss County of Subscribed and sworn to or affirmed before me by Witness my hand and official seal* Notary Public My Commission Expires Effective April 2011.