Victim Rights Request & Waiver Form

This following constitutional amendment tells about your rights as a victim. Please read this and indicate your preference on the form below. Have a witness verify and include their information. Then, simply send us the form by pressing the submit button. Thank you for your cooperation.

Constitutional Amendment

Victims of crime or their lawful representatives, including the next of kin of homicide victims, are entitled to the right to be informed, to be present, and to be heard when authorized, at all crucial stages of the criminal proceedings, to the extent that these rights do not interfere with the constitutional rights of the accused. Act # 95-583; State of Alabama

Intake #

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I have received the printed pamphlet advising me of my (Victim, Guardian or Next of Kin) constitutional rights and:

I. Victim Information

Victim's Name

Victim’s Email Address:

Victim's Mailing Address

Victim's Telephone (day)

Victim's Telephone (evening)

Victim's Date of Birth

Victim's SSN

Victim's Driver's License (DL) #

Victim's DL State

II. Family Contact Information

Family Contact / Next of Kin

Contact's Date of Birth

Contact's SSN

Contact's Driver's License (DL) #

Contact's DL State

Contact's Telephone (day)

Contact's Telephone (evening)

III. Witness Information

Witness Name

Witness Mailing Address

Witness Telephone (day)

Witness Telephone (evening)

Email updates

Email Address for Notifications

Opt In for email notifications

Victim Rights Request & Waiver Form​

Constitutional Amendment

I. Victim Information

II. Family Contact Information

III. Witness Information

Email updates

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