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Form 4 Affidavit of violations of mental health court program

Baldwin's Kentucky Revised Statutes Annotated9th Judicial Circuit - Hardin Mental Health Court

Baldwin's Kentucky Revised Statutes Annotated
9th Judicial Circuit - Hardin Mental Health Court
Forms
KY HMHC Form 4
Form 4 Affidavit of violations of mental health court program
Currentness
Commonwealth of Kentucky
Court of Justice
HARDIN COUNTY
MENTAL HEALTH COURT
COMMONWEALTH OF KENTUCKY
PLAINTIFF
AFFIDAVIT OF
VS.
VIOLATIONS OF MENTAL
NO.
HEALTH COURT
PROGRAM
DEFENDANT
Comes the affiant, Stephen W. Hill, and after first being duly sworn, states that he is the Coordinator of the Hardin County Mental Health Court for the Commonwealth of Kentucky.
The affiant states that the defendant had the following violation(s):
Empty Checkbox​
Did not attend hearing
Empty Checkbox​
Did not attend treatment meetings
Empty Checkbox​
Did not comply with service plan
Empty Checkbox​
Failed drug screen
Empty Checkbox​
Committed
 
on
 
(offense)
(date)
Empty Checkbox​
Other (please explain)
 
Stephen W. Hill
Coordinator
Hardin County Mental Health Court
Subscribed and sworn to before me by
 
on this
__________
day of
__________
,
__________
.
Attested Copies to:
By: ____________________________ D.C.

Credits

HISTORY: Adopted effective October 17, 2011.
Hardin Mental Health Court Form 4, KY R HARDIN MNTL HLTH CT Form 4
Current with amendments received through November 15, 2023. Some rules may be more current, see credits for details.
End of Document