FORM A | (r. 3(1)) |
THE PETITION OF POWER OF MERCY |
To: | The President |
| Republic of Kenya |
| Through |
| The Power of Mercy Advisory Committee |
| |
1. The humble petition of .............................................................................................................. |
(Name of convicted criminal offender) |
Prison No ...................................................Nationality ................................................................. |
Name of Prison where held ............................................................................................................ |
Court where convicted .................................................................................................................... |
Court Case No. ............................................................................................................................... |
Age at conviction ........................................ Current Age ............................................................... |
Age when offence was committed ................................................................................................... |
Next of kin .................................................................................................................................... |
Relationship .................................................................................................................................. |
Contact person ................................................................ Tel. No ................................................... |
Home County ................................................. Sub-County ........................................................... |
Location ....................................................................................................................................... |
Nearest School ............................................................................................................................. |
Name of Home Chief ..................................................................................................................... |
Where the offence was committed ................................................................................................. |
Date of conviction .......................................................................................................................... |
Date of custody (remand) ............................................................................................................... |
2. Number of counts and sentence terms(s) imposed ............................................................................................................................................................................................................................... |
3. Relief sought or nature of the petition (tick as appropriate) |
(a) Free or conditional pardon |
(b) Postponing the carrying out of a punishment for a specified or indefinite period |
(c) Substituting a less severe form of punishment |
(d) Remitting all or part of punishment |
4. The nature, particulars and circumstances surrounding the commission of the offence |
.................................................................................................................................................................................................................................................................................................................... |
(attach a separate sheet for additional information where necessary) |
5. Were you charged alone for the offence? |
(a) Yes | (b) No | if No, gives Names of the co-accused and prison held if they were convicted |
.................................................................................................................................................................................................................................................................................................................... |
6. Do you know the victim of the offence for which you were charged? |
(a) Yes | (b) No | if yes, provide details. |
Name of victim ....................................................................................................................... |
Area of residence (if known) ......................................................................................................................... |
7. State and explain any previous conviction(s).......................................................................................................................................................... |
8. Has the prisoner made any previous petition? ............................................................................................................................. |
(a) If yes, Date of the previous petition was .................................................................................... |
(b) Reason of denial of previous petition .......................................................................................... |
9. Reasons for current petition.................................................................................................................................................................................................................................................................................................................... |
10. Any Documents submitted in support of the petition.................................................................................................................................................................................................................................................................................................................... |
11. Have you had any disciplinary action taken against you while in prison?Give details ................................................................................................................................................................................................................................................................................................ |
12. Any special condition e.g. physical ability challenges, terminal sickness, verysickly, mental health etc. .................................................................................................................................................................................................................................................................................. |
13. Are you a Trustee .................................................................................................................. |
(a) Yes | (b) No | if yes, please explain .............................................................................. |
14. Are you recognized for special attributes, achievement or skills attained in prison? |
(a) Yes | (b) No | if yes, please explain ...................................................................................... |
15. Did you appeal against the conviction? |
(a) Yes | (b) No | if yes, please explain the outcome and indicate the Appeal Case Number ...................................................................................................... |
16. Do you have any pending court matter even if not related to your conviction? |
(a) Yes | (b) No | if yes, please explain ....................................................................................... |
|
The Petitioner further states: |
17. That during the service of the sentence term, the convicted criminal offender has demonstrated good conduct, change of character, and remorse for the crime for which the prisoner was convicted and sentenced |
18. That the petitioner humbly requests the President of the Republic of Kenya to exercise the power of mercy and grant the relief sought. |
19. That the petitioner binds himself/herself to the conditions that may be attached to any relief granted by the President, including post release supervision by any government agency. |
20. That the convicted criminal offender commits and undertakes to maintain and improve on the good character and recognizes that should the relief be granted it could be revoked, upon recommendation of the Power of Mercy Advisory Committee, in the event of commission of any criminal offence. |
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Dated at ............this ............day of. ................ 20 ................ |