22 CRR-NY D VI Form 15NY-CRR

STATE COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK
TITLE 22. JUDICIARY
SUBTITLE D. FORMS
CHAPTER VI. FORMS FOR USE IN COURTS EXERCISING CRIMINAL JURISDICTION
22 CRR-NY D VI Form 15
22 CRR-NY D VI Form 15
15 Elimination or relaxation of conditions of probation
 
Form 15
 
(Elimination or Relaxation of
 
Conditions of Probation)
 
1/87
ELIMINATION OR RELAXATION OF SPECIFIED CONDITIONS OF PROBATION
APPLICATION
STATE OF NEW YORK
 
)
 
 
) ss.:
 
COUNTY OF
__
 
)
_________, being duly sworn, deposes and says:
I am a probation officer with the
 
Department of Probation. I am responsible for
[County]
supervising the probation of
 
[Name of Probationer]
who was convicted of (adjudicated a youthful offender for the act of) [Date of conviction],
on [Name of Court] by the __, and was sentenced by [Name of Judge/Justice]
to __.
Based upon the following ( ) new information ( ) change in circumstances
 
 
 
 
,
pursuant to C.P.L. §§ 410.20 and 410.40, the
 
Department
 
[County]
of Probation respectfully requests that probationer's conditions of probation be modified as follows
 
 
 
(Signature)
Sworn to before me this __ day of __, 19.
Notary Public
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COURT ORDER
The above application by the
 
Department
[County]
of Probation is granted to the extent that, effective as of
__
19
, the conditions of probation are modified as follows
 
 
 
Judge (Justice)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
NOTICE TO PROBATIONER
YOU HEREBY ARE NOTIFIED THAT YOUR CONDITIONS OF PROBATION HAVE BEEN MODIFIED AS SET FORTH IN THE ABOVE ORDER, EFFECTIVE AS OF THE DATE SPECIFIED IN SUCH ORDER. Notification mailed ( ) served upon ( ) probationer: __, 19
22 CRR-NY D VI Form 15
Current through May 31, 2021
End of Document