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

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

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

Court that issued the release order ____________

County Court of the county wherein the defendant is now residing ____________

____________

Term of the Supreme Court for the county wherein the defendant is now residing ________________________

(3) This application for a discharge order is made pursuant to subdivision 13 of C PL 330.20.

(4) The 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 this 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) Subsequent to the order referred to in paragraph (4) of this application, the following court issued a transfer order on the following date:

[Name of court] ____________

[Date of transfer order] ____________

(9) Subsequent to the issuance of the order referred to in paragraph (4) of this application, the following court issued a release order and an order of conditions on the following date:

[Name of court] ____________

[Date of release order and order of conditions] ____________

(10) The above-named defendant has been continuously on an outpatient status for three years or more pursuant to the release order and order of conditions referred to in paragraph (9) of this application.

(11) This application is made upon the ground that the undersigned is of the view that the above-named defendant no longer has a dangerous mental disorder and is no longer mentally ill and that the issuance of a discharge order is consistent with the public safety and welfare of the community and the defendant.

(12) The reasons for the view stated by the undersigned in paragraph (11) of this application are as follows:

____________

____________

____________

____________

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WHEREFORE, the undersigned respectfully requests that this application be granted and that a discharge order issue terminating the order of conditions referred to in paragraph (9) of this application. unconditionally discharging the above-named defendant from supervision under the provisions of C PL 330.20.

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Signature

______________

Type or Print Name

______________

Title

NOTICE OF APPLICATION FOR A DISCHARGE ORDER

To: