Victim Notification Request
In compliance with 944.605 Florida Statutes

Use this form to request that the Department of Corrections provide you with notification of inmate status changes. You may use this form to send changes in your address, telephone number(s), or other necessary information. Requests for updates can also be sent via regular mail by printing and completing the Victim Notification Request Form and sending it to: Florida Department of Corrections, Victim Assistance Office, 2601 Blair Stone Road, Tallahassee, Florida 32399-2500.

For additional information on our services, see the Victim Assistance Office information.

** Please do not use this Victim Notification Request Form if you are a family member or friend of the inmate and you are not the victim. **

Is this a new or updated request?

New Request
Updates to Previous Request

Information about you:

1.	Your Name:
2.	Your Address:
3.	City, State Zip:
4.	Telephone: (Please include Area Code.)	Home: Work: Cell: Note: Giving us your telephone number(s) will automatically register you to receive automated notification calls from our VINE Service each time the inmate's movement changes (release, transfer, escape, death, out-to-court). Telephone numbers must be direct lines to you and cannot go through a switchboard, nor will it work if you have a service that announces your calls before connecting the call to you.
5.	Do you want the VINE Service? -Yes -No
6.	E-mail Address:

Victim Information:

1.	Victim Name:
2.	Your relationship to the Victim:
3.	If Victim is a minor, Victim's date of birth:
3.	Is the Victim deceased? -Yes -No
4.	Your relationship to the inmate:
5.	If you are the victim, survivor or representative for the victim, this is your opportunity to provide us with important information. If you are not the victim/survivor/representative, please explain why you wish to be notified. Please indicate whether you have been threatened, if you are in fear for your safety or the safety of your family.

Inmate Information:
Please provide all information, if known. Whatever information you can provide will help us to ensure we have you registered on the correct inmate. Please complete a separate notification form for each inmate.

1.	Inmate Name:
2.	DC Number:
3.	Date of Birth:
4.	Race:
5.	Sex:
6.	Social Security Number:
7.	Crime:
8.	County:
9.	Sentence:
10.	Case Number:

For assistance, please call our office toll-free at 1-877-884-2846, Monday through Friday, 8 a.m. to 5 p.m. Eastern Standard Time. You may also call directly to the VINE Service for inmate information toll-free at 1-877-846-3435, 24 hours a day, 7 days a week.

Note: If you register directly with the VINE Service your information is not shared with the Florida Department of Corrections - Victim Assistance Office. If you fill out this online Victim Notification Request Form with your new request or your updated information, it will be added to the Florida Department of Corrections - Victim Notification Database and provided to the VINE Service if requested. Victim information is "Confidential" per state law and inmates do not have access to victim information.

Victim Notification Request In compliance with 944.605 Florida Statutes

Victim Notification Request
In compliance with 944.605 Florida Statutes