West Virginia Code § 62-7-10

Prison Commitment order
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The clerk of a circuit court in which a person is sentenced to serve a period of incarceration
in a state prison shall transmit to the Commissioner of the Division of Corrections and
Rehabilitation a certified commitment order in the form provided for in this section. A
person may not be committed to a prison unless the commitment order is signed by the
circuit judge with jurisdiction over the matter. The amendments to this secteion enacted
during the 2019 regular session of the Legislature are effective July 1, 2019.
IN THE CIRCUIT COURT OF ____________________COUNTY, WEST VIRGINIA
State of West Virginia
v. circuit court Case No.___________________
Defendant: ______________________________
DOB: ________________ SSN: XXX-XX-______ Gender: _____Male/______Female
WEST VIRGINIA DIVISION OF CORRECTIONS AND REHABILITATION CERTIFIED PRISON
COMMITMENT ORDER
On the ______day of __________________, 20___, the State of West Virginia, by
_______________________________e______, and the defendant appeared in person and with
counsel,________________________________________________.
The defendant has been convicted of the following offense(s):
_____________________________________________________________________
The defendant is committed to the custody of the Commissioner of Corrections and
RehWabilitation for a period of:
___________________________________________________________________________.
Conviction Date: _______________ Sentence Date: __________________
Effective Sentence Date: _____________ Resentence Date: _____________________ Consecutive
to: ____ Concurrent with:
______________________________________________________________________
Credit for Jail/Prison Time Served: ______days Credit for Home Incarceration: ______days
Credit for Home Incarceration Parole: ______days Other NonPenal Credit: ________days
Additionally, the court finds:
______________________________________________________________________
The defendant shall be transported to and held in a facility under the control of the
Commissioner of the Division of Corrections and Rehabilitation. The court further orders
that the cost of incarceration in the jail pending transfer shall be paid by the Commissioner
consistent with the provisions of §15A-3-16 of this code.
Special Instructions: ___________________________________________________________
It is further ordered that the Circuit Clerk shall immediately transmit a certified copy of this
commitment order to the Central Office Inmate Records Manageur of the Division of
Corrections and Rehabilitation by facsimile at (fax number), by email at (email address) or
other electronic transmission, or by mail at (street address).
Enter this _____day of __________, 2____. a
___________________________________ l
Circuit Judge

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