New Jersey Administrative Code
Title 10A - CORRECTIONS
Chapter 20 - RESIDENTIAL COMMUNITY REINTEGRATION PROGRAM (RCRP)
Subchapter 1 - GENERAL PROVISIONS
Section 10A:20-1.5 - Forms

Universal Citation: NJ Admin Code 10A:20-1.5

Current through Register Vol. 56, No. 6, March 18, 2024

(a) The following forms are used for internal purposes by the Department related to the RCRP and are available through the Office of Community Programs:

1. 686--I Community Program Application;

2. 686--II Community Program Application Checklist; and

3. MR-030 Community Reintegration Medical Examination Form.

(b) The following forms related to the Furlough Program shall be reproduced by each correctional facility from the original that is available by contacting the New Jersey State Parole Board:

1. I-4 Request for Pre-Parole Report;

2. 822--A Pre-Parole Report.

(c) The following form is related to the accounting process as used by the RCRP when billing the Department of Corrections. The form shall be reproduced from the original that is available by contacting the New Jersey Department of Corrections, Division of Programs and Community Services, Office of Community Programs:

1. AR 50/54--State of New Jersey Payment Voucher (Vendor Invoice).

(d) The following forms are used for internal purposes by the Residential Community Reintegration Program and are available through the Office of Community Programs:

1. 171-1 Seizure of Contraband forms used for internal purposes by the Residential Community Reintegration Program are available through the Office of Community Programs Report;

2. 171-II Inmate Receipt, Contraband Seizure;

3. 172--II Continuity of Evidence--On-Site Urine Specimen Testing;

4. 285-II Prohibited Substance Testing Request Summary;

5. 259 Disciplinary Report;

6. Monthly Indicator Report;

7. RCRP Weekly Employment and School Report;

8. Special Incident Report Form OCP-001;

9. CA:44.2a Escape Report Form;

10. CA:44.2b Disciplinary/Administrative/Walk-Away Escape Discharge Summary;

11. RCRP Situational Report;

12. HVAC RCRP Special Report Form;

13. Staffing Roster;

14. Financial Contributions Report;

15. Live Count Sheet;

16. Daily Population Sheet;

17. Secondary Testing Analysis;

18. Prohibited Substance Testing Positive Results;

19. Notification of Staff Change;

20. Request for Transfer;

21. Tours/Application for Clearance/Construction, Tours and Escorted Access Only;

22. NJDOC, RCRP, Contract Vendor Employees, Volunteers and Interns--Application for Clearance and Issuance of ID Cards;

23. TASC Testing RCRP Reimbursement Invoice;

24. Educational Waiver or Request to Withdraw;

25. P.A.C.T. Request Form;

26. Furlough Request Form;

27. Employment/Education Variance Request Form;

28. OCP Bedside/Private Viewing Visit;

29. Admission Notification to Law Enforcement;

30. Employment Notification to Law Enforcement;

31. Social Services Inmate Emergency Contact/Family Information Form;

32. NJDOC Fair Release and Reentry Act (FRARA) 2009 RCRP Supplemental Form;

33. Reentry Services for People Leaving DOC Facilities and the RCRPs Referral Form;

34. Universal Property Pick-up Form;

35. Form 380-I Eng-Span Marriage Request Form;

36. Consent for Disclosure of Substance Use Disorder Records Form;

37. Employment and Education Site Monitoring Form;

38. P.R.E.P.A.R.E./NJ Helps Screening Form; and

39. RCRP Initial Jobsite Employer Participation Agreement.

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