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Pardon Application

The document outlines the application process for a presidential pardon after completing a sentence, detailing what a pardon can and cannot do, as well as eligibility requirements. It provides guidance on how to fill out the application, including necessary personal information and supporting documents, and explains the timeline and communication process with the Office of the Pardon Attorney. Additionally, it emphasizes the importance of accuracy in responses and the potential consequences of providing false information.

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duy.idemitsu
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0% found this document useful (0 votes)
26 views24 pages

Pardon Application

The document outlines the application process for a presidential pardon after completing a sentence, detailing what a pardon can and cannot do, as well as eligibility requirements. It provides guidance on how to fill out the application, including necessary personal information and supporting documents, and explains the timeline and communication process with the Office of the Pardon Attorney. Additionally, it emphasizes the importance of accuracy in responses and the potential consequences of providing false information.

Uploaded by

duy.idemitsu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 24

OMB Number: 1123-0016 Expiration Date: 5/31/2027

Application for Pardon After Completion of Sentence


What Is a Pardon and How Can It Help You?
Pardon is asking forgiveness from the President.
Pardon CAN: Pardon CANNOT:
• Restore civil liberties, like the right to vote, • Erase a conviction
or sit on a jury • Expunge a conviction
• Lift barriers to licensing, employment,
housing, or education

To apply, you should:


• Have a conviction under federal law, D.C. Code, or Uniform Code of Military Justice
• Live in the U.S. or its territories

If you are still serving your sentence, use the commutation application form: justice.gov/pardon/apply-
commutation

How to Begin:
Filling out and submitting the application is the first step in a lengthy process. You will be asked to
share details about yourself, your reasons for seeking pardon, your current activities, challenges
you may be facing because of your conviction, information about your conviction and other
criminal history, if any, and letters of support.
It is not required, but it may help to gather these WHERE CAN I FIND DOCUMENTS
documents, if available, before you start: RELATED TO MY CONVICTION?

1. Presentence investigation report You may be able to get the judgment,


indictment, information, and case docket
This report is prepared by the U.S. Probation report online:
Office to help the court with sentencing.
2. Judgment Federal cases: PACER (has fees):
uscourts.gov/court-records/find-case-pacer
This document shows what sentence the
court gave you. D.C. cases:
dccourts.gov/superior-court/cases-online
3. Statement of reasons
This document gives the court’s reasons for For documents that aren’t available online, you
the sentence (not applicable in D.C. Code or military can contact or go to the court clerk’s office:
cases).
Federal court clerk’s offices:
4. Indictment or Information
uscourts.gov/about-federal-courts/federal-
These documents list the charges against courts-public/court-website-links
you.
D.C. Superior Court:
5. Case docket report dccourts.gov/superior-court/criminal-division
The docket lists all the events in the case.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 1 of 24
When will the Office of the Pardon Attorney (PARDON) contact you?

The pardon application process can take months or years. We ask that you keep your contact
information updated so that we can reach you when needed. Until the notification of the
President’s final decision, your application is “pending” or open. Messages from PARDON
during the process DO NOT predict the final decision. No outcome is guaranteed. Common
situations when we may contact you include:

Confirmation Follow-Up Background Notification of


Letter Letters Investigation Final Decision
We will send an We may send We will let you We will let you
email or letter emails or letters know if a know if the
confirming your asking for more background President has
application has information or investigation has granted or denied
been received updates been started pardon

HELPFUL TIPS
• This application asks for information to help us get a better picture of you and
your life. All questions are important. Answer all questions to the best of your
knowledge and ability and give as much detail as you can.
• The application asks for a large amount of personal information that may
require research and collecting documents from the past. You may need
several sessions to complete the application.
• To help us process your application more quickly, if an answer does not apply
to you, write “Not Applicable.”
• Sending your application as a PDF by email will help us process your
application more quickly.
• If you mail the application, stapling, gluing, or taping any part will slow down
processing.
• If you need more space, you can add pages or documents.
• If there is information you feel would make your application stronger, include
it in additional pages. You can tell us about achievements, like physical
fitness training or accomplishments; participation in personal growth, like
counseling, therapy, or meditation; or other ways you have spent your time
that tell us about who you are today.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 2 of 24
Table of Contents

A. Background Information.…………………………………………………………………….6
We need to know who is applying for pardon, to confirm your identity, and to be sure any background
investigation is accurate.
B. Reasons for Seeking Pardon………………………………………………………………..8
We need to understand how your conviction has affected your life and what you hope pardon will change
or improve.
Additional Information About Your Life Since Your Conviction (Parts C-I):
We need the questions in sections C-I (pages 9-14) to help us get a better picture of your life since your
conviction, including your successes and the challenges you may have faced.
C. Community Activities…………………………………………………………………………9
D. Educational and Licensing Opportunities…………………………………………………10
E. Places Lived…………………………………………………………………………...…….11
F. Military Service…………………………………………………………………………...….11
G. Job History………………………………………………………………………………......12
H. Sobriety and Substance Use…………………………………………………………...….13
I. Financial Information…………………………………………………………………...……14

J. Case Background and Other Criminal History……………………………………….......15


We need to make sure we have the correct case and understand your offense conduct. It also gives you a
chance to explain any other criminal history that may appear in a background investigation.
K. Certification and Personal Oath……………………………………………………………18
We need your signature to know that you are submitting the pardon application willingly and that you
have answered the questions accurately, to the best of your ability.
L. Authorization for Release of Information…………………………………………………..19
The authorization lets us and any investigators get information and documentation about your life. If we
need information about medical or mental health history, we will ask you for a separate authorization.

M. Letters of Support…………………………………………………………………………..20
We need to know how you interact with your community, who you are now, and what your life looks like
since your conviction. We need at least three letters. If you give us more than three letters, let us know
which three will be your primary references. Primary references cannot be related to you by blood or
marriage and must be willing to be interviewed during a background investigation.
N. Application Checklist……………………………………………………………………….23
This checklist will help you review your application to make sure it is complete. It also tells you where to
submit the application and how to keep your contact information updated.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 3 of 24
Know Your Rights and How Your Information Will be Used

Who is collecting this information and what are my rights?


The Office of the Pardon Attorney collects your information to review and make recommendations to the
President on pardon applications. The Office is part of the Department of Justice, which is a federal
government agency. You have the right not to give information to us. If you do not answer some of the
questions, however, we cannot guarantee that we will be able to continue working on your application.
How will my information be used under the Privacy Act?
The principal purpose for collecting this information is to enable the Office of the Pardon Attorney to
process and evaluate your request for pardon after completion of sentence. The routine uses which may
be made of this information include provision of data to the President and his staff, other governmental
entities, and the public. The full list of routine uses for this correspondence can be found in the System
of Records Notice titled, “Privacy Act of 1974; System of Records,” published in Federal Register,
September 15, 2011, Vol. 76, No. 179, at pages 57078 through 57080; as amended by “Privacy Act of
1974; System of Records,” published in the Federal Register, May 25, 2017, Vol. 82, No. 100, at page
24161, and at the U.S. Department of Justice, Office of Privacy and Civil Liberties’ website.
The Office of the Pardon Attorney has authority to collect this information under the United States

Constitution, Article II, Section 2 (the pardon clause); Orders of the Attorney General Nos. 1798-93, 58
Fed. Reg. 53658 and 53659 (1993), 2317-2000, 65 Fed. Reg. 48381 (2000), and 2323-2000, 65 Fed.
Reg. 58223 and 58224 (2000), codified in 28 C.F.R. §§ 1.1 et seq. (the rules governing petitions for
pardon after completion of sentence); and Order of the Attorney General No. 1012-83, 48 Fed. Reg.
22290 (1983), as codified in 28 C.F.R. §§ 0.35 and 0.36 (the authority of the Office of the Pardon
Attorney).

Can the government publish my information?


If you are granted or denied pardon by the President, your name will be released, including on our
website or in response to public information requests, in accordance with our Freedom of Information Act
obligations. Non-public documents, such as this petition and supporting documents, the presentence
investigation report, the results of any federal background investigation, and the recommendation of the
Department of Justice, are not generally available under the Freedom of Information and Privacy Acts.
However, the Pardon Attorney may disclose the contents of pardon files in the possession of the
Department of Justice when the disclosure is required by law or the ends of justice. Additionally, this
office would confirm that a specific individual has applied for or was granted or denied pardon.
The President and his immediate staff are not subject to the constraints of the Freedom of Information
and Privacy Acts. Accordingly, while pardon-related documents in the possession of the White House
traditionally have not been made public, they may be legally disclosed at the discretion of the President.
In addition, pardon-related documents retained by the White House at the end of a presidential
administration will become part of the President’s official library, where they become subject to the
disclosure provisions of the Presidential Records Act.

Answer questions as accurately and as fully as you can, to the best of your knowledge.
Making any intentionally false statements of material facts may be a reason for denying your petition. In
addition, the knowing and willful falsification of a document submitted to the government may subject
you to criminal punishment, including up to five years’ imprisonment and a $250,000 fine. See 18 U.S.C.
§§ 1001 and 3571.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / March 2024 Page 4 of 24
Public Burden Statement
This collection meets the requirements of 44 U.S.C. § 3507, as amended by the Paperwork Reduction Act
of 1995. We estimate that it will take 180 minutes to read the instructions, gather the relevant materials,
and answer questions on the form. Send comments regarding the burden estimate or any other aspect of
this collection of information, including suggestions for reducing this burden, to Attn: Office of the
Pardon Attorney, U.S. Department of Justice, Attn: OMB Number 1123-0016, RFK Building, 950
Pennsylvania Avenue, N.W., Washington, D.C. 20530. The OMB clearance number, 1123-0016, is
currently valid. PARDON may not collect this information, and you are not required to respond, unless
this number is displayed.

Note: Nothing in this application or instructions is legal advice.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 5 of 24
A. Background Information
a. Applicant information
Full name:

First name Middle name (if you have one) Last name

If different, full legal name at time of conviction:

First name Middle Name (if you have one) Last name

Other names (married, maiden, aliases, etc.) Social security number

Date of birth (Month, Day, Year) Country where you City and state where you
were born were born

Citizenship: ☐ U.S. citizen by birth


Parent #1’s full name (maiden name in parentheses)
☐ U.S. naturalized citizen


Parents #2’s full name (maiden name in parentheses) Other nationality

b. Contact information

Street address Apartment/Unit City, State Zip code


Email is the best way to contact you. If you do not have email, you can give the email of a person you trust,
or your phone number. If an attorney is helping you with this application, also give their information:

Your email address or email of a trusted person Phone number

Name of attorney helping with this Attorney’s email address and phone number
application

c. Previous applications

Have you applied for ☐ Yes Date applied (month/year):


federal commutation
or pardon before? ☐ No Date of decision (month/year):

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / March 2024 Page 6 of 24
d. Sex and race. This information is for statistical data collection purposes:

Are you Hispanic or Race (select all that apply): Sex


Latino? ☐ Alaska Native or American ☐ Asian
Indian ☐ Female
☐ Yes ☐ Native Hawaiian or
☐ Black or African American Other Pacific Islander ☐ Male
☐ No
☐ White ☐ Other

e. Family information. For this section, it would be helpful to have dates for:
• Your marriage (if applicable)
• Your divorce (if applicable)
• Your children’s birth dates (if applicable)

Current marital status Current spouse / partner information, if applicable:

☐ Civil union/domestic partnership


Spouse / partner name
☐ Divorced ☐ Married
Date of marriage or civil union/domestic partnership
☐ Never Married ☐ Separated

☐ Widowed Place of marriage or civil union/domestic partnership

Child or dependent information, if applicable:


Full name of child or Date of birth Name(s) of other parent(s) Do you have
dependent custody? (Y/N)

Former spouse or partner information, if applicable:

Former spouse or partner name Phone number

Date of marriage or civil union/domestic partnership Date of divorce

Place of marriage or civil union/domestic partnership Place of divorce

Check here if you are attaching additional pages. Add the section name to the top of each page.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 7 of 24
B. Reasons for Seeking Pardon
What are your reasons for seeking pardon?
The more specific you can be, the better. Use the space below and/or attach additional pages.

You may want to include:


• How your life would change if granted pardon
• Challenges that you have faced because of your conviction

If you have ever been denied a job, license, or other opportunity because of your conviction,
attaching denial letters or related documents will help us review your application

Check here if you are attaching additional pages. Add the section name to the top of each page.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 8 of 24
C. Community Activities
How have you been involved in your community since your conviction?
“Community” can include family, neighborhood, city, prison community, or organizations and
associations. If you have more than three activities, attach additional pages. Some examples are:
• Assisting in extracurricular and education-related activities of children and grandchildren
• Providing support to community members, such as neighbors and family members
• Providing care to an aging relative
• Service with a civic or religious organization or a professional association
• Involvement in the prison community, including as tutor, mentor, or suicide watch companion
If you have not been able to participate in these activities, explain below.

Description of activity Approximate start


and end dates (year
to year)

Who can tell us about your participation in the above activities?


Name(s) Contact information

Is there anything you would like us to know about your reasons for engaging in community
activities? If you have not been able to participate in these activities, you can let us know why here.

Check here if you are attaching additional pages. Add the section name to the top of each page.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 9 of 24
D. Educational and Licensing Opportunities
What educational or licensing opportunities have you had?
These can be programs you have started or completed, including courses you completed and licenses
you earned while incarcerated. Some examples are:
• College correspondence courses • Vocational training
• Associate, bachelor, master programs • Commercial driver’s license (CDL) courses
• Department of Labor courses • Licenses: cosmetology, real estate, nursing,
• Certificate programs teaching, welding, electrician, or other

If you need more space, attach additional pages.

School or program name Subject studied and degree or Approximate


certification received dates attended
(month/year to
month/year)

License Type Approximate date


issued (year)

We know that people with a criminal record may have trouble getting into educational programs or
receiving licenses. If that applies to you, give details here. If you have them, you can attach any denial or
decision letters from licensing officials or related documents.

School or program name or Details Approximate date of


license type denial or when
informed not
eligible (year)

Check here if you are attaching additional pages. Add the section name to the top of each page.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 10 of 24
E. Places Lived
Where have you lived in the last three years?

We already have your current address from your background information.


• Do not use P.O. Boxes. • If you have lived in more than three places,
• Give apartment/unit numbers. attach additional pages.
• Do not leave any gaps in dates.
If there were any periods where you did not have housing, you can note that below.
Street address Apartment City, state Zip code Approximate dates
/Unit living there (month/
year to month/year)

If you are experiencing homelessness or


have in the past, note the dates.
(month/year to month/year)

F. Military Service
Have you served in the military? ☐ Not applicable

Dates of service Branch(es)

Serial number Type of discharge

Tell us briefly about your military service. For example, any tours of duty, time overseas or in active
combat, disciplinary sanctions or military criminal proceedings taken against you, commendations or
medals awarded to you, or other notable achievements. If available, attach a copy of your DD-214.

Check here if you are attaching additional pages. Add the section name to the top of each page.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 11 of 24
G. Job History
Where have you worked in the last seven years?
• Include full and part-time jobs • If you have had more than three jobs,
• If applicable, include jobs while incarcerated attach additional pages
• Use approximate dates • If you are retired, give the approximate date
• Do not leave any gaps in dates your retirement began in the “Current
employer” section

Current employer Type of business Position Month/year started

Employer street address City, state Zip code Supervisor name and phone
number

Previous Type of Position Employer address Approximate dates


employer name business and phone number worked (month/year
to month/year)

If you are currently unemployed or have been in the past, give the dates and share how you supported
yourself during that time.

If your criminal record has affected your ability to find work, give details here. If you received a rejection
letter or termination notice because of your conviction, you can attach a copy.

Your work history will be reviewed as part of any background investigation. If you have been fired,
accused of misconduct at a job, or given an unsatisfactory job performance rating, give details here.

Check here if you are attaching additional pages. Add the section name to the top of each page.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 12 of 24
H. Sobriety and Substance Use
Have you struggled with substance use? ☐ Not applicable
We know that many people have struggled with substance use and that this can be difficult to discuss.
Your honest reflection is helpful to us.

Type of drug or alcohol How often were you using? Approximate dates used
(month/year to month/year)

If you have been diagnosed with a substance use disorder, give details here.

Diagnosis Date of diagnosis (month/year)

Give information on any counseling or treatment you received or rehabilitation program you
attended for substance use.

Facility/counselor/doctor name When did you attend?


(month/year to month/year)

Street address Suite no. City, state Zip code

Phone number Email address

How long have you been sober?


Days, months, or years

Is there anything else you would like to share about your history with sobriety and substance use?

Check here if you are attaching additional pages. Add the section name to the top of each page.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 13 of 24
I. Financial Information
Do you have any debts that are late or in default (including child support payments) or do you
have any bankruptcy filings?

We know that criminal convictions may affect some people’s ability to get a job and may carry heavy
financial penalties, making it harder to keep up with necessary expenses. We know this can be a hard
subject to discuss. Your honest reflection is helpful to us.

• Note: A credit report will be reviewed if a background investigation is started.

Description of debt that is late or in default Approximately how much


is the debt?

Court where bankruptcy filed Approximate year Approximately how much


bankruptcy filed and debt did you want to
outcome discharge?

Is there anything else you would like to share about your experience with finances since your
conviction?
This may include information on why you are unable to pay the above debts or filed for bankruptcy
and any plans to catch up on payments for any debts that are late or in default.

Check here if you are attaching additional pages. Add the section name to the top of each page.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 14 of 24
J. Case Background and Other Criminal History
a. Give basic information on the conviction for which you are seeking pardon.
If you are seeking pardon for more than one conviction, attach additional pages.

It is not required, but, if available, sending a copy of these documents with your application will help
us review your case more quickly. See cover page for more information.
• Presentence report • Indictment or Information
• Judgment • Case docket report
• Statement of reasons

☐ Check here if you are attaching any of these documents.

Did you plead guilty? ☐ Yes ☐ No

Approximate date(s) of offense (month/year to Approximate date you were sentenced


month/year) (month/year)

Court where you were prosecuted (D.C. Superior Court, Case number
military court, or name of U.S. District Court)

Of what were you convicted?

What sentence did you receive? (fill in where applicable)

Imprisonment:
Prison sentence (months or years) Approximate date you were released from
prison, community confinement, or home
detention (month/year)

Probation or
supervised
release: Sentence for probation or supervised Approximate date you completed your term
release (months or years) of probation or supervised release
(month/year)

Financial
penalties:
Assessment amount Fine amount Restitution amount

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 15 of 24
b. Tell us about your conduct for which you were convicted.

We want to hear from you, in your own words. The more specific and complete you are, the more helpful
it is to us. We are specifically looking for information that is NOT in the public record of your case. You
may wish to answer the following:
• What was your role in the offense?
• How, when, and why did you get involved?
• What actions did you take in connection with the offense? (Include all actions, even if you
pleaded guilty to only specific conduct, counts, or portions of the full criminal activity.)

Do you accept responsibility for your conduct? Explain why or why not.

Check here if you are attaching additional pages. Add the section name to the top of each page.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 16 of 24
c. Tell us about any other criminal history.

Your criminal history will be reviewed as part of any background investigation. List any other arrests or
convictions that may appear on your criminal history record, if any, including juvenile and expunged
records, and give any information you would like us to know about them. If you have your presentence
report, you may attach it and give missing or additional information you would like us to know below.

. Check here if you are attaching additional pages. Add the section name to the top of each page.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 17 of 24
K. Certification and Personal Oath

I certify, under penalty of perjury, that all information in my petition and any document submitted with
it were given or authorized by me and that I reviewed and understand the information contained in,
and submitted with, my petition. I further certify, under penalty of perjury, that all the information I
gave in the application is complete, true, and correct to the best of my knowledge, information, and
belief.

In petitioning the President of the United States for pardon, I do solemnly swear that I will be law-
abiding and will support and defend the Constitution of the United States against all enemies,
foreign and domestic, and that I take this obligation freely and without any mental reservation
whatsoever.

Respectfully submitted this day of , .


Day Month Year

Your signature

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 18 of 24
L. Authorization for Release of Information

Carefully read this authorization, and if you agree, sign and date in ink.
I authorize any investigator, special agent, or other duly accredited representative of the Federal Bureau of
Investigation, the Department of Defense, and any other authorized Federal agency, to obtain any
information relating to my activities from schools, residential management agents, employers, criminal
justice agencies, retail business establishments, courts, or other sources of information. This information
may include, but is not limited to, my academic, residential, achievement, performance, attendance,
disciplinary, employment history, criminal history, arrest, conviction, including the presentence
investigation report, if any, medical, psychiatric/psychological, health care, and financial and credit
information.

I understand that, for financial or lending institutions and certain other sources of information, a separate
specific release may be needed (pursuant to their request or as may be required by law), and I may be
contacted for such a release at a later date.

I further authorize the Federal Bureau of Investigation, the Department of Defense, and any other
authorized Federal agency, to request criminal record information about me from criminal justice agencies
for the purpose of determining my suitability for a government benefit.

I authorize custodians of records and sources of information pertaining to me to release such


information upon request of the investigator, special agent, or other duly accredited representative of
any Federal agency authorized above regardless of any previous agreement to the contrary. I understand
that the information released by records custodians and sources of information is for official use by the
Federal Government only for the purposes of processing my application for a government benefit, and
may be redisclosed by the Government only as authorized by law.

Copies of this authorization that show my signature are as valid as the original release signed by me. If
not previously revoked in writing, this Authorization is valid and shall remain in effect so long as I am
under consideration for a government benefit.

Signature (sign in ink)

Full Name (type or print legibly) Date Signed

Other Names Used

Street Address

City State ZIP Code

Home Telephone Number (include area code) Social Security Number

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 19 of 24
M. Letter of Support
☐ Primary reference (select exactly 3)

on behalf of
Name of petitioner

I certify that I have personally known the petitioner for years and am not related to petitioner
by blood or marriage.

In support of this pardon petition, I state the below:

NOTE: The information below should be based on your personal knowledge of the petitioner. Helpful
information includes:

• How you know the individual,


• What you know of their reputation and conduct since their conviction, and
• Their personal and professional activities, including at work, at home, and in the community.

☐ Check here if you are attaching additional pages.

I affirm that the above information is true and correct to the best of my knowledge, information,
and belief.

Signature Print Name

Date Address

Phone number

Email address
United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 20 of 24
M. Letter of Support
☐ Primary reference (select exactly 3)

on behalf of
Name of petitioner

I certify that I have personally known the petitioner for years and am not related to petitioner
by blood or marriage.

In support of this pardon petition, I state the below:

NOTE: The information below should be based on your personal knowledge of the petitioner. Helpful
information includes:

• How you know the individual,


• What you know of their reputation and conduct since their conviction, and
• Their personal and professional activities, including at work, at home, and in the community.

☐ Check here if you are attaching additional pages.

I affirm that the above information is true and correct to the best of my knowledge, information,
and belief.

Signature Print Name

Date Address

Phone number

Email address
United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 21 of 24
M. Letter of Support
☐ Primary reference (select exactly 3)

on behalf of
Name of petitioner

I certify that I have personally known the petitioner for years and am not related to petitioner
by blood or marriage.

In support of this pardon petition, I state the below:

NOTE: The information below should be based on your personal knowledge of the petitioner. Helpful
information includes:

• How you know the individual,


• What you know of their reputation and conduct since their conviction, and
• Their personal and professional activities, including at work, at home, and in the community.

☐ Check here if you are attaching additional pages.

I affirm that the above information is true and correct to the best of my knowledge, information,
and belief.

Signature Print Name

Date Address

Phone number

Email address
United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 22 of 24
N. Application Checklist
1. Gather the following information.
Required Optional

☐ Application form (pages 6-17) ☐ Official records: presentence report, judgment,


statement of reasons, indictment or
☐ Signed certification and personal oath
information, or court docket record
(page 18)
☐ Personal records supporting answers
☐ Signed and completed Authorization for
Release of Information form (page 19) ☐ Additional pages to complete answers
☐ 3 signed letters of support from non-relatives ☐ Additional pages with any information you feel
(pages 20-22) would make your application stronger.
Note: You MUST select exactly 3 as your
primary letters

2. Submit your application.


NOTE: Keep a copy of everything you submit for your personal records
For general pardon applications
The fastest way to submit your application is by email. If you send it by mail, it may take longer to process.

By email By mail
Email documents in PDF or Word format to U.S. Dep’t of Justice, Office of the Pardon Attorney
USPardon.Attorney@usdoj.gov 950 Pennsylvania Avenue, N.W.
Washington, D.C. 20530

For pardon of a general court-martial conviction only


Submit your application to the military department that had original jurisdiction in your case.
NOTE: Send a single PDF not exceeding 10 MB in size

U.S. Army: U.S. Navy/U.S. Marine Corps:


Office of the Judge Advocate General Office of the Judge Advocate General
ATTN: Criminal Law Division, (DAJA-CL) Criminal Law Division (Code 20)
2200 Army Pentagon 1254 Charles Morris Street S.E., Suite B01
Washington, D.C. 20310-200 Washington Navy Yard, D.C. 20374
usarmy.pentagon.hgda-otjag.list.cld-ops-army-
executive-pardons@army.mil NavyPardonRequests@us.navy.mil

U.S. Air Force: U.S. Coast Guard:


Office of the Judge Advocate General Commandant (CG-LMJ)
Attention: AF/JAJI U.S. Coast Guard Headquarters
1500 W. Perimeter Road, Suite 1300 2703 Martin Luther King Jr. Avenue S.E.
Joint Base Andrews Washington, D.C. 20032
Naval Air Facility, MD 20762
AF.JAJIWorkflow@us.af.mil HQS-DG-LST-CG-LMJ@uscg.mil

NOTE: Pardon of a military offense will not change the character of a military discharge
United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 23 of 24
3. Keep your contact information updated.
We will need to reach you during the pardon process. If your contact information changes, email us at
USPardon.Attorney@usdoj.gov or send a letter to our mailing address.

The application process:


1. Confirmation letter – We will send an email or letter letting you know we received your
application and if it is missing any parts. If you have not received a confirmation after three
months, email USPardon.Attorney@usdoj.gov (preferred) or send a letter to our mailing
address. You can check the status of your case on the Pardon Attorney’s website:
justice.gov/pardon/search-clemency-case-status.
2. Follow-up letters – It may take some time for review of your application to start. During the
review, we may need more information or updates to your application. If we do, we will contact
you by email (preferred) or mail.
3. Background investigation – During the review of your application, a background investigation
may be necessary. The investigation is conducted by agents of the Federal Bureau of
Investigation (FBI). We will let you know by email (preferred) or mail if we have asked for a
background investigation. It may include interviews of you, the people who wrote your letters of
support, neighbors, former and present employers, acquaintances, and other individuals who
may be able to give relevant information about you. The agent will be discreet and make
reasonable efforts not to disclose the reason for the investigation, but we cannot guarantee that
those interviewed will not learn that you are seeking pardon for a past criminal conviction.
4. Notification of final decision – You will be notified when a final decision is made by the
President. This may take years. No hearing will be held and there is no appeal from the
President’s decision to deny a request for pardon.

United States Department of Justice, Office of the Pardon Attorney, Washington D.C. / May 2024 Page 24 of 24

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