Form CN1501 "Inmate Consent to Interview" - Connecticut

What Is Form CN1501?

This is a legal form that was released by the Connecticut State Department of Correction - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 31, 2009;
  • The latest edition provided by the Connecticut State Department of Correction;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form CN1501 by clicking the link below or browse more documents and templates provided by the Connecticut State Department of Correction.

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Download Form CN1501 "Inmate Consent to Interview" - Connecticut

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Inmate Consent to Interview
CN 1501
REV 1/31/09
Connecticut Department of Correction
I,
Inmate name
Inmate number
consent to be interviewed and/or photographed
do not consent to be interviewed and/or photographed
by
name of interviewer or photographer
of
name of news outlet
on
date
I understand that the statement(s) and photograph(s) obtained during this interview or
photographic opportunity may be used in publications or audio or video presentations produced by
the Department of Correction or in publications or broadcasts prepared by other organizations.
I agree to receive no consideration for consenting to be interviewed or to be photographed.
I understand that the Department of Correction has no control of the use of my statement(s) and/or
photographs in publications or broadcasts prepared by other organizations.
On behalf of myself and my heirs and assigns, I release the State of Connecticut and the
Department of Correction from any and all claims that may otherwise accrue to me as the result of
the publication of my statement(s) obtained during this interview or from the publication or
broadcasts of my photograph(s) obtained during the photographic opportunity.
It shall be the inmate’s responsibility to notify their attorney.
Inmate signature:
Date:
Witness name:
Title:
Witness signature:
Date:
Inmate Consent to Interview
CN 1501
REV 1/31/09
Connecticut Department of Correction
I,
Inmate name
Inmate number
consent to be interviewed and/or photographed
do not consent to be interviewed and/or photographed
by
name of interviewer or photographer
of
name of news outlet
on
date
I understand that the statement(s) and photograph(s) obtained during this interview or
photographic opportunity may be used in publications or audio or video presentations produced by
the Department of Correction or in publications or broadcasts prepared by other organizations.
I agree to receive no consideration for consenting to be interviewed or to be photographed.
I understand that the Department of Correction has no control of the use of my statement(s) and/or
photographs in publications or broadcasts prepared by other organizations.
On behalf of myself and my heirs and assigns, I release the State of Connecticut and the
Department of Correction from any and all claims that may otherwise accrue to me as the result of
the publication of my statement(s) obtained during this interview or from the publication or
broadcasts of my photograph(s) obtained during the photographic opportunity.
It shall be the inmate’s responsibility to notify their attorney.
Inmate signature:
Date:
Witness name:
Title:
Witness signature:
Date: