5. An application for temporary absence for a family visit must contain(1) the inmate’s name;
(2) the inmate’s date of birth;
(3) the inmate’s record number;
(4) the reason supporting the temporary absence for a family visit;
(5) a description of the proposed temporary absence including conditions such as the dates on which the inmate is to leave and return to the facility, duration of the absence, destination and transportation used;
(6) the name and address of the person to be visited; and
(7) an attestation from the correctional services that the person to be visited has been reached and has agreed to accommodate the inmate for the duration of the absence for a family visit, at the address and on the conditions stated in the application for temporary absence.