Form DOC09-264 "Request and Authorization Administrative - Dismiss Without Prejudice (Dwop)" - Washington

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Download this version of Form DOC09-264 for the current year.

What Is Form DOC09-264?

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

Form Details:

  • Released on April 15, 2019;
  • The latest edition provided by the Washington State Department of Corrections;
  • 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 DOC09-264 by clicking the link below or browse more documents and templates provided by the Washington State Department of Corrections.

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Download Form DOC09-264 "Request and Authorization Administrative - Dismiss Without Prejudice (Dwop)" - Washington

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REQUEST AND AUTHORIZATION ADMINISTRATIVE
DISMISS WITHOUT PREJUDICE (DWOP)
REQUEST
This request is for an Administrative DWOP to retain the Department’s ability to take action on a future conviction.
Offender Name
DOC number
Supervision Type(s):
Date of Law Violation(s):
Current Supervised Cause(s):
Failure to Obey all Laws Violation(s) to be dismissed without prejudice:
Community Corrections Officer
Signature
Date
Office
AUTHORIZATION – HEARINGS DECISION
Administrative DWOP granted. The above violation(s) may be addressed in the future and sanctions may be imposed.
Administrative DWOP denied.
Reason(s) for Denial:
Hearings Administrator/designee or Hearings
Signature
Date
Duty Officer
The contents of this document may be eligible for public disclosure. Social Security Numbers are considered confidential information and
will be redacted in the event of such a request. This form is governed by Executive Order 16-01, RCW 42.56, and RCW 40.14. Upon
completion, the data classification category may change.
Distribution: ORIGINAL – Hearings Duty Officer via
dochearingsdo@doc.wa.gov
COPY – Imaging System via docswiftcertain@doc.wa.gov, Field File, Offender
DOC 09-264 (Rev. 04/15/19)
Page 1 of 1
DOC 460.130, DOC 460.140
Scan Code VI17
Data classification category 1
REQUEST AND AUTHORIZATION ADMINISTRATIVE
DISMISS WITHOUT PREJUDICE (DWOP)
REQUEST
This request is for an Administrative DWOP to retain the Department’s ability to take action on a future conviction.
Offender Name
DOC number
Supervision Type(s):
Date of Law Violation(s):
Current Supervised Cause(s):
Failure to Obey all Laws Violation(s) to be dismissed without prejudice:
Community Corrections Officer
Signature
Date
Office
AUTHORIZATION – HEARINGS DECISION
Administrative DWOP granted. The above violation(s) may be addressed in the future and sanctions may be imposed.
Administrative DWOP denied.
Reason(s) for Denial:
Hearings Administrator/designee or Hearings
Signature
Date
Duty Officer
The contents of this document may be eligible for public disclosure. Social Security Numbers are considered confidential information and
will be redacted in the event of such a request. This form is governed by Executive Order 16-01, RCW 42.56, and RCW 40.14. Upon
completion, the data classification category may change.
Distribution: ORIGINAL – Hearings Duty Officer via
dochearingsdo@doc.wa.gov
COPY – Imaging System via docswiftcertain@doc.wa.gov, Field File, Offender
DOC 09-264 (Rev. 04/15/19)
Page 1 of 1
DOC 460.130, DOC 460.140
Scan Code VI17
Data classification category 1