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
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 ________
