(a) An application for a reprieve shall be made to the governor and shall contain: (i) The name of the person seeking the reprieve; (ii) The offense for which he was convicted; (iii) The date and place of the conviction; (iv) The sentence imposed; (v) The sentence served; (vi) Any subsequent arrests, criminal charges, convictions or sentences; and (vii) Any other pertinent information the governor may request. (b) The governor's warrant granting a reprieve shall list any conditions upon which the reprieve is granted. The person accepting the reprieve shall agree in writing to any conditions contained in the warrant. (c) The warrant of reprieve with the acceptance signed by the person granted the reprieve shall be filed with the clerk of the sentencing court as a part of the record in the case.
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