DD Form 499 Prisoner's Mail and Correspondence Record

DD Form 499 - also known as the "Prisoner's Mail And Correspondence Record" - is a United States Military form issued by the Department of Defense.

The form - often incorrectly referred to as the DA form 499 - was last revised on March 1, 2013. Download an up-to-date fillable PDF version of the DD 499 below or request a copy through the chain of command.

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PRISONER'S MAIL AND CORRESPONDENCE RECORD
1. PRISONER NAME
2. REGISTRATION NUMBER
3. MARITAL STATUS
(Last, First, Middle Initial)
(X one)
Single
Married
Divorced
Legally Separated
4. AUTHORIZED CORRESPONDENTS
(Name, Relationship,
a. INCOMING MAIL
b. OUTGOING MAIL
and Address (Include ZIP Code))
(Date)
(Date)
(Facility/Brig Commander must approve all correspondence.)
(1)
CDR's Initials:
Approved
Disapproved
(2)
CDR's Initials:
Approved
Disapproved
(3)
CDR's Initials:
Approved
Disapproved
(4)
CDR's Initials:
Approved
Disapproved
(5)
CDR's Initials:
Approved
Disapproved
(6)
CDR's Initials:
Approved
Disapproved
(7)
CDR's Initials:
Approved
Disapproved
(8)
CDR's Initials:
Approved
Disapproved
(9)
CDR's Initials:
Approved
Disapproved
(10)
CDR's Initials:
Approved
Disapproved
5.
I REQUEST THAT PERSON(S) LISTED ABOVE BE APPROVED AS MY AUTHORIZED CORRESPONDENTS.
6.
a. EXCEPT FOR PRIVILEGED CORRESPONDENCE, I DO NOT DESIRE TO SEND AND/OR RECEIVE MAIL.
b. I UNDERSTAND THAT ALL INCOMING MAIL WILL BE INSPECTED. INAPPROPRIATE MAIL WILL BE RETURNED TO THE SENDER
IF A RETURN ADDRESS IS SHOWN OR HELD FOR ME UNTIL MY RELEASE IF IT CANNOT BE RETURNED TO THE SENDER.
(If applicable, attach 5 x 8 card to identify and record action taken on all correspondence not delivered to prisoner.)
PRIVILEGED CORRESPONDENCE.
NOTE: All privileged correspondence can be opened in the presence of the prisoner to whom it is addressed.
7.
Privileged correspondence opened for inspection shall not be read unless authorized to do so based on the results of an inspection or otherwise. Privileged
correspondence is defined as correspondence between a prisoner and: the President, the Vice President, members of Congress, the Attorney General, Judge
Advocate General or military or civilian attorney on record, his/her representatives, State and Federal court officials, defense counsel, or any military or civilian
attorney of record who represents the prisoner. All correspondence with the Inspector General will be privileged.
8. VICTIM/WITNESS COORDINATION SCREENING
(Requirement to screen this form prior to Commander's Approval)
Initials Required:
9.a. SIGNATURE OF PRISONER
b. DATE
(YYYYMMDD)
DD FORM 499, MAR 2013
Adobe Professional X
PREVIOUS EDITION IS OBSOLETE.
PRISONER'S MAIL AND CORRESPONDENCE RECORD
1. PRISONER NAME
2. REGISTRATION NUMBER
3. MARITAL STATUS
(Last, First, Middle Initial)
(X one)
Single
Married
Divorced
Legally Separated
4. AUTHORIZED CORRESPONDENTS
(Name, Relationship,
a. INCOMING MAIL
b. OUTGOING MAIL
and Address (Include ZIP Code))
(Date)
(Date)
(Facility/Brig Commander must approve all correspondence.)
(1)
CDR's Initials:
Approved
Disapproved
(2)
CDR's Initials:
Approved
Disapproved
(3)
CDR's Initials:
Approved
Disapproved
(4)
CDR's Initials:
Approved
Disapproved
(5)
CDR's Initials:
Approved
Disapproved
(6)
CDR's Initials:
Approved
Disapproved
(7)
CDR's Initials:
Approved
Disapproved
(8)
CDR's Initials:
Approved
Disapproved
(9)
CDR's Initials:
Approved
Disapproved
(10)
CDR's Initials:
Approved
Disapproved
5.
I REQUEST THAT PERSON(S) LISTED ABOVE BE APPROVED AS MY AUTHORIZED CORRESPONDENTS.
6.
a. EXCEPT FOR PRIVILEGED CORRESPONDENCE, I DO NOT DESIRE TO SEND AND/OR RECEIVE MAIL.
b. I UNDERSTAND THAT ALL INCOMING MAIL WILL BE INSPECTED. INAPPROPRIATE MAIL WILL BE RETURNED TO THE SENDER
IF A RETURN ADDRESS IS SHOWN OR HELD FOR ME UNTIL MY RELEASE IF IT CANNOT BE RETURNED TO THE SENDER.
(If applicable, attach 5 x 8 card to identify and record action taken on all correspondence not delivered to prisoner.)
PRIVILEGED CORRESPONDENCE.
NOTE: All privileged correspondence can be opened in the presence of the prisoner to whom it is addressed.
7.
Privileged correspondence opened for inspection shall not be read unless authorized to do so based on the results of an inspection or otherwise. Privileged
correspondence is defined as correspondence between a prisoner and: the President, the Vice President, members of Congress, the Attorney General, Judge
Advocate General or military or civilian attorney on record, his/her representatives, State and Federal court officials, defense counsel, or any military or civilian
attorney of record who represents the prisoner. All correspondence with the Inspector General will be privileged.
8. VICTIM/WITNESS COORDINATION SCREENING
(Requirement to screen this form prior to Commander's Approval)
Initials Required:
9.a. SIGNATURE OF PRISONER
b. DATE
(YYYYMMDD)
DD FORM 499, MAR 2013
Adobe Professional X
PREVIOUS EDITION IS OBSOLETE.

Download DD Form 499 Prisoner's Mail and Correspondence Record

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