New York Codes, Rules and Regulations
Title 22 - JUDICIARY
Subtitle D - Forms
Chapter VI - Forms For Use In Courts Exercising Criminal Jurisdiction
Form 13 - Judicial reprimand of probationer

Current through Register Vol. 45, No. 52, December 27, 2023

Sec. 410.40 C.P.L. FORM 13

(Judicial Reprimand

of Probationer)

1/87

JUDICIAL REPRIMAND OF PROBATIONER

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 petitioner's failure to ____________

____________

____________,

pursuant to C.P.L. §§410.20

______

[County] Department of Probation requests the Court to

order probationer personally to appear before the Court at the time and place set forth below.

______________

(Signature)

Sworn to before me this

________ day of ________, 19________.

______________

Notary Public

COURT ORDER

The above application by the ____________ Department of

[County]

Probation is granted. The probationer is directed to appear before the Court on ________ at ________ (a.m.) (p.m.) in Part ________ at ________. This order shall be (mailed to) (served personally upon) the probationer.

______________

Judge (Justice)

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

NOTICE TO PROBATIONER

YOU HAVE BEEN ORDERED TO APPEAR BEFORE THE COURT AT THE ABOVE TIME AND PLACE. FAILURE TO APPEAR AS ORDERED WITHOUT REASONABLE CAUSE THEREFOR CONSTITUTES A VIOLATION OF THE CONDITIONS OF YOUR SENTENCE OF PROBATION, AND MAY RESULT IN REVOCATION OF YOUR PROBATION AND ISSUANCE OF A WARRANT DIRECTING THAT YOU BE TAKEN INTO CUSTODY AND BROUGHT BEFORE THE COURT.

Date mailed ( ) served upon ( ) probationer:________, 19 ________

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