New York Codes, Rules and Regulations
Title 22 - JUDICIARY
Subtitle D - Forms
Chapter II - Cpl Section 330.20 Forms
Forms (cf. Part 110)
Form O - Application for transfer order and notice of application

(1) The undersigned is authorized by the State Commissioner of Mental Health to submit this application for a transfer order for and on behalf of the said Commissioner.

(2) This application for a transfer order is being submitted to the following court: [check one and print name and address of indicated court]

Court that issued the order under which the above-named defendant is now in custody ____________

County Court of the county wherein the facility in which the defendant is confined is located: ____________

Term of the Supreme Court for the county wherein the facility in which the defendant is confined is located: ____________

(3) his application for a transfer order is made pursuant to subdivision 11 of C PL 330.20.

(4) he above-named defendant was committed to the custody of the State Commissioner of Mental Health for confinement in a secure facility for care and treatment pursuant to a commitment order issued under the provisions of subdivision 6 of C PL 330.20

a recommitment order issued under the provisions of subdivision 14 of C PL 330.20

by the following court on the following date:

[Name of court] ____________

[Date of order] ____________

(5) Subsequent to the issuance of the order referred to in paragraph (4) of this application, the following court issued a first retention order on the following date:

[Name of court] ____________

[Date of first retention order] ____________

(6) Subsequent to the issuance of the first retention order referred to in paragraph (5) of this application, the following court issued a second retention order on the following date:

[Name of court] ____________

[Date of second retention order] ____________

(7) Following the issuance of the second retention order referred to in paragraph (6) of this application, the following court issued a subsequent retention order on the following date:

[Name of court] ____________

[Date of each subsequent retention order, including last subsequent retention order] ____________

(8) Pursuant to the order referred to in paragraph (4) paragraph (5) paragraph (6) paragraph (7) of this application, the above-named defendant is currently confined in the following secure facility of the State Office of Mental Health: ____________

(9) This application is made upon the ground that the undersigned is of the view that the above-named defendant does not have a dangerous mental disorder.

that consistent with the public safety and welfare of the community and the defendant, the clinical condition of the defendant warrants his transfer from a secure facility to a nonsecure facility under the jurisdiction of the Commissioner of Mental Health the following nonsecure facility designated by the Commissioner of Mental Health ____________

____________

(10) The annexed psychiatric reports are made a part of this application for a transfer order and support the view stated by the undersigned in paragraph (9) of this application.

(11) Written notice of this application for a transfer order has been given to the above-named defendant, counsel for the defendant, the Mental Health Information Service and the District Attorney.

(12) No previous application for a transfer order has been made to any court.

WHEREFORE, the undersigned respectfully requests that this application be granted and that a transfer order issue authorizing the Commissioner of Mental Health to transfer the above-named defendant from a secure facility to a nonsecure facility under the jurisdiction of the said Commissioner to the following nonsecure facility designated by the said Commissioner: ____________

______________

Signature

______________

Type or Print Name

______________

Title

Date: ________

NOTICE OF APPLICATION FOR A TRANSFER ORDER

To: