TELEPHONE APPLICATION
NORTH DAKOTA DEPARTMENT OF CORRECTIONS AND REHABILITATION
SFN 50076 (12-2025)

Para ver esta aplicación en español, use el menú desplegable en la parte superior derecha de esta aplicación.

APPLICANT INSTRUCTIONS

1. The family member or friend (Applicant) completing this form must answer accurately and truthfully.
2. All fields must be complete. Failure to complete all fields will result in a denied application.
3. The information on this form will be seen by the Resident, as the Resident must approve all telephone numbers added to their active calling list.
4. The Resident will submit the application to the facility telephone administrator. All applications must come from the Resident.
5. The Telephone Application is available in electronic and fillable/printable formats on the North Dakota Department of Corrections and
   Rehabilitation (ND DOCR) website at www.docr.nd.gov by clicking "Family & Friends" in the top navigation bar, then clicking "Telephone
   Calls" in the drop-down menu.

APPLICANT SIGNATURE

My signature below confirms that:

1. I have read and fully understand all information given on this form; AND
2. All information I provided in this application is true and correct.

I understand that providing false information on this form is grounds for denying telephone privileges.