AF Form 4289 "Monthly Confinement Report and Victim/Witness Activity Concerning Inmate Status"

AF Form 4289 is a U.S. Air Force form also known as the "Monthly Confinement Report And Victim/witness Activity Concerning Inmate Status". The latest edition of the form was released in June 15, 2015 and is available for digital filing.

Download an up-to-date AF Form 4289 in PDF-format down below or look it up on the U.S. Air Force Forms website.

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Download AF Form 4289 "Monthly Confinement Report and Victim/Witness Activity Concerning Inmate Status"

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FOR OFFICIAL USE ONLY (When Filled In)
MONTHLY CONFINEMENT REPORT AND VICTIM/WITNESS ACTIVITY CONCERNING INMATE STATUS
DSN PHONE NUMBER
REPORTING MONTH
STATUS CHANGES / REASON CODES
1 - TELEPHONE
A - INITIAL NOTIFICATION/ELIGIBILITY DATES
D - NOTIFICATION OF ESCAPE
G - NOTIFICATION OF EMERGENCY PAROLE (EP)
2 - WRITTEN
B - NOTIFICATION OF CLEMENCY/PAROLE
E - NOTIFICATION OF RE-CONFINEMENT
H - NOTIFICATION OF DEATH
C - NOTIFICATION OF RELEASE
F - NOTIFICATION OF TRANSFER
I - OTHER
MRD
Sex
IV. Sentence
XI. Notification Reason
XII.
Notification
Offender
Notified
Type of
Notification
On
Off
Total
Month
Discharge
V
W
V
W
(See Above, i.e., 2A, 2A/2B)
Required
Base
Base
Totals:
Totals:
Total:
a
The above confinees were confined during this reporting period. Victim (V)/Witness (W)/Sex Offender Notifications were made as annotated via DD Form 2705, Victim Witness Notification of Inmate Status,
and DD FORM 2791. Notice of Release/Acknowledgment of Convicted Sex Offender Registration Requirements. In addition, a DD Form 2791 and Report of Result of Trial have been emailed encrypted to
afsfc.sfcv@us.af.mil (AF Corrections) for placement in the Registered Sex Offenders e-ARMs record, IAW AFI 31-105, as applicable.
Signature of Confinement Officer
Dat
Typed or Printed Name and Grade of Confinement Officer
AF FORM 4289, 20150615
FOR OFFICIAL USE ONLY (When Filled In)
MONTHLY CONFINEMENT REPORT AND VICTIM/WITNESS ACTIVITY CONCERNING INMATE STATUS
DSN PHONE NUMBER
REPORTING MONTH
STATUS CHANGES / REASON CODES
1 - TELEPHONE
A - INITIAL NOTIFICATION/ELIGIBILITY DATES
D - NOTIFICATION OF ESCAPE
G - NOTIFICATION OF EMERGENCY PAROLE (EP)
2 - WRITTEN
B - NOTIFICATION OF CLEMENCY/PAROLE
E - NOTIFICATION OF RE-CONFINEMENT
H - NOTIFICATION OF DEATH
C - NOTIFICATION OF RELEASE
F - NOTIFICATION OF TRANSFER
I - OTHER
MRD
Sex
IV. Sentence
XI. Notification Reason
XII.
Notification
Offender
Notified
Type of
Notification
On
Off
Total
Month
Discharge
V
W
V
W
(See Above, i.e., 2A, 2A/2B)
Required
Base
Base
Totals:
Totals:
Total:
a
The above confinees were confined during this reporting period. Victim (V)/Witness (W)/Sex Offender Notifications were made as annotated via DD Form 2705, Victim Witness Notification of Inmate Status,
and DD FORM 2791. Notice of Release/Acknowledgment of Convicted Sex Offender Registration Requirements. In addition, a DD Form 2791 and Report of Result of Trial have been emailed encrypted to
afsfc.sfcv@us.af.mil (AF Corrections) for placement in the Registered Sex Offenders e-ARMs record, IAW AFI 31-105, as applicable.
Signature of Confinement Officer
Dat
Typed or Printed Name and Grade of Confinement Officer
AF FORM 4289, 20150615
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