Online Application Form : Prisoner Release Victim Information Scheme

Online Application Form

A printable version of the application form is available here


	Online Application Form Having read the leadlet on the Prisoner Release Victim Information Scheme I would like to apply to receive information about a prisoner. My Details
	Name:
	Address:

	Postcode:
	Telephone:
	I wish to receive the following infromation: (Please tick all that apply):
	Final Discharge Details:
	Temporary Release Details:
	If you were contacted by the police on behalf of the Prisoner Release Victim Information Unit about this scheme you are not required to complete the next section on Details of Offence. Instead please quote the case reference number which can be obtained from the PSNI correspondence.
	Case Reference:
	Details of Offence To help us identify your case please give us as much details about the offence as possible. Relevant information would be the name of offender (if known), date of offence, location of offence and nature of offence.
	I would like a chosen representitive to receive information on my behalf:
	Details of Representative
	Name:
	Organisation:(if applicable)
	Address1:
	Address2:
	Postcode:
	Contact Telephone Number:
	Relationship to Victim: