State Seal
Kansas Sentencing Commission

700 S.W. Jackson, Suite 501 | Topeka, Kansas 66603 | Ph:785.296.0923| Fax: 785.296.0927 | E-mail:

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Death in Custody Forms

PLEASE NOTE THAT THE DEATH IN CUSTODY REPORT FORM IS NOW DUE

ONLY TWICE PER CALENDAR YEAR:

REPORTING PERIODS:

-JANUARY 1ST - JUNE 30TH, the report is DUE by August 1st.

-JULY 1ST - DECEMBER 31ST, the report is DUE February 1st.

The interactive forms provided below can by submitted by email, or filled out, printed, and mailed to the Sentencing Commission.

If you have difficulty completing the form AND there are no reported deaths, you may simply send an email to Office@sentencing.ks.gov stating that for the particular period there are no deaths to report for your agency. The email will serve as documentation.

The form may be mailed to:

Attention DICR
Kansas Sentencing Commission
700 SW Jackson, Ste 501
Topeka, KS 66603

You will need AdobeAcrobat Reader to access these files, which may be downloaded off this page.

Informational Flyer

Calendar Year 2010 Forms

Death in Custody CJ -11

Death in Custody Addendum CJ -11A

Calendar Year 2009 Forms

Death in Custody CJ -11

Death in Custody Addendum CJ -11A

Calendar Year 2008 Forms

Death in Custody (use for deaths prior to January 1, 2009)

Death in Custody Addendum (use for deaths prior to January 1, 2009)