Motion for Furlough

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MOTION FOR FURLOUGH / TEMPORARY RELEASE

TABLE OF CONTENTS

  1. Caption
  2. Defendant / Inmate Information
  3. Grounds for Furlough
  4. Statutory Authority
  5. Proposed Conditions of Release
  6. Risk Assessment
  7. Supporting Documentation
  8. Proposed Order
  9. Certificate of Service
  10. North Carolina Practice Notes

1. CAPTION

STATE OF NORTH CAROLINA
IN THE GENERAL COURT OF JUSTICE
SUPERIOR COURT DIVISION
[________________________________] COUNTY

STATE OF NORTH CAROLINA,
File No. [________________________________]
v.
[________________________________],
Defendant/Inmate.

MOTION FOR FURLOUGH / TEMPORARY RELEASE


2. DEFENDANT / INMATE INFORMATION

Field Details
Full Legal Name [________________________________]
NCDAC Offender ID Number [________________________________]
Date of Birth [__/__/____]
Current Facility [________________________________]
Housing Unit / Cell [________________________________]
Date of Commitment [__/__/____]
Sentence Imposed [________________________________]
Felony Class [________________________________]
Projected Release Date [__/__/____]
Maximum Sentence Expiration [__/__/____]
Current Custody Classification [________________________________]

3. GROUNDS FOR FURLOUGH

COMES NOW the Defendant/Inmate, [________________________________], by and through counsel, [________________________________], and respectfully moves this Court for an order granting or supporting furlough / temporary release on the following grounds:

Type of Furlough Requested

☐ Medical Release (N.C. Gen. Stat. § 15A-1369 et seq.)
☐ Work Release (N.C. Gen. Stat. § 148-33.1)
☐ Community Leave / Temporary Outside Activity Pass (N.C. Gen. Stat. § 148-4)
☐ Study / Training Leave
☐ Maternity Leave (limited to 60 days)
☐ Palliative Care Leave
☐ Emergency Leave (funeral, visiting sick relative)

Specific Grounds

[________________________________]
[________________________________]
[________________________________]

Duration Requested

Start Date Requested [__/__/____]
End Date Requested [__/__/____]
Total Duration [________________________________]

4. STATUTORY AUTHORITY

A. Medical Release (N.C. Gen. Stat. § 15A-1369 et seq.)

The Post-Release Supervision and Parole Commission may grant medical release when an inmate is:

  • Terminally ill: diagnosed with a condition likely to cause death within six months;
  • Geriatric: aged and infirm, posing low public safety risk; or
  • Permanently disabled: suffering from a permanent physical incapacity that precludes continued imprisonment from serving a penological purpose.

B. Work Release (N.C. Gen. Stat. § 148-33.1)

The Secretary of the Department of Adult Correction may authorize work release for eligible inmates in the final stage of their sentence with a positive behavior record and appropriate custody classification.

C. Temporary Leave (N.C. Gen. Stat. § 148-4)

The Secretary may grant temporary leave for approved activities including community service, study/training, emergency visits, and other authorized purposes.

D. Medical Release Exclusions (N.C. Gen. Stat. § 15A-1369.1)

The following inmates are excluded from medical release:

  • Inmates convicted of a capital felony
  • Inmates convicted of Class A, B1, or B2 felonies
  • Inmates required to register as sex offenders under Article 27A of Chapter 14

5. PROPOSED CONDITIONS OF RELEASE

The Defendant/Inmate proposes the following conditions during the furlough period:

☐ Comply with prescribed medical release plan
☐ Supervision by the Division of Community Supervision
☐ Reside at approved address: [________________________________]
☐ Surrender work release earnings to the Division of Prisons for authorized deductions
☐ Return to facility at the end of each workday or leave period
☐ For community leave: accompanied by trained volunteer escort
☐ Submit to electronic monitoring
☐ Submit to drug and alcohol testing
☐ Refrain from contact with: [________________________________]
☐ Other: [________________________________]

Proposed Residence / Placement (if Medical Release)

Address [________________________________]
Relationship to Inmate [________________________________]
Contact Person [________________________________]
Phone Number [________________________________]
Medical Care Provider [________________________________]

6. RISK ASSESSMENT

A. Institutional Conduct Record

[________________________________]
[________________________________]

☐ No disciplinary infractions during the past [____] months/years
☐ Disciplinary history attached as Exhibit [____]

B. Program Participation

[________________________________]
[________________________________]

C. Custody Classification

Current custody level: [________________________________]

☐ Appropriate classification for requested release type

D. Community / Public Safety Assessment

The Defendant/Inmate presents a low risk to public safety because:

[________________________________]
[________________________________]
[________________________________]

E. Medical Assessment (if Medical Release)

Diagnosis: [________________________________]
Prognosis: [________________________________]
Treating Physician: [________________________________]

☐ Terminal illness with life expectancy of six months or less
☐ Geriatric condition with low public safety risk
☐ Permanent physical incapacity


7. SUPPORTING DOCUMENTATION

The following exhibits are attached in support of this Motion:

☐ Exhibit A: Medical records / physician's certification (if medical release)
☐ Exhibit B: Institutional conduct record
☐ Exhibit C: Custody classification report
☐ Exhibit D: Program participation certificates
☐ Exhibit E: Employment verification (if work release)
☐ Exhibit F: Proposed residence verification
☐ Exhibit G: Medical release plan (if medical release)
☐ Exhibit H: Letters of support from family / community members
☐ Exhibit [____]: [________________________________]


8. PROPOSED ORDER

STATE OF NORTH CAROLINA
IN THE GENERAL COURT OF JUSTICE
SUPERIOR COURT DIVISION
[________________________________] COUNTY

ORDER ON MOTION FOR FURLOUGH / TEMPORARY RELEASE

The Court, having considered the Motion for Furlough filed by Defendant/Inmate [________________________________], and good cause appearing:

IT IS HEREBY ORDERED that:

  1. The Motion for Furlough is GRANTED / SUPPORTED.
  2. The Defendant/Inmate is authorized for furlough / temporary release from [__/__/____] to [__/__/____].
  3. The Defendant/Inmate shall comply with all conditions imposed by the Division of Community Supervision / Division of Prisons.
  4. The following additional conditions shall apply: [________________________________]

DATED this [____] day of [________________________________], [____].

___________________________________________
Superior Court Judge
[________________________________] County, North Carolina


9. CERTIFICATE OF SERVICE

I hereby certify that on [__/__/____], a true and correct copy of the foregoing Motion for Furlough was served upon the following parties:

Party Method Address
[________________________________] County District Attorney ☐ Hand Delivery ☐ U.S. Mail ☐ Electronic Service [________________________________]
North Carolina Department of Adult Correction ☐ Hand Delivery ☐ U.S. Mail ☐ Electronic Service [________________________________]
Post-Release Supervision and Parole Commission (if medical release) ☐ Hand Delivery ☐ U.S. Mail ☐ Electronic Service [________________________________]
Victim(s) / Victim Advocate (if applicable) ☐ Hand Delivery ☐ U.S. Mail ☐ Electronic Service [________________________________]

___________________________________________
[________________________________]
Attorney for Defendant/Inmate
North Carolina State Bar No. [________________________________]
[________________________________]
[________________________________]
Phone: [________________________________]
Email: [________________________________]


10. NORTH CAROLINA PRACTICE NOTES

  1. Medical Release Authority: The Post-Release Supervision and Parole Commission decides medical release under N.C. Gen. Stat. § 15A-1369 et seq.

  2. Work Release / Temporary Leave: The Secretary of the Department of Adult Correction administers work release (§ 148-33.1) and temporary leave (§ 148-4).

  3. Medical Release Exclusions: Inmates convicted of capital felonies, Class A/B1/B2 felonies, and registered sex offenders under Article 27A of Chapter 14 are excluded from medical release.

  4. Duration Limits:
    - Community leave passes: maximum 6 hours
    - Maternity leave: limited to 60 days
    - Medical release: through sentence expiration date

  5. Work Release Earnings: Earnings must be surrendered to the Division of Prisons for deductions including keep, restitution, and support.

  6. Community Leave Escorts: Community leave activities require trained volunteer escorts.

  7. Work Release Restrictions: Work release is prohibited for inmates working for family members or operating their own businesses.

  8. Mandatory Return: Inmates must return to the facility at the end of each workday or leave period.


This template is provided for informational purposes only by ezel.ai and does not constitute legal advice. North Carolina furlough statutes are subject to change. Consult a licensed North Carolina attorney and verify all citations before filing.

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About This Template

Criminal law paperwork covers every stage of a criminal case, from the first appearance and bail motion through pretrial motions, plea agreements, sentencing, and appeals. Deadlines in criminal cases are short and often unforgiving, and constitutional rights can be waived just by missing a filing. Using the right motion at the right time can mean the difference between evidence getting suppressed, charges getting reduced, or a case getting dismissed entirely.

Important Notice

This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.

Last updated: April 2026