New York Codes, Rules and Regulations
Title 22 - JUDICIARY
Subtitle D - Forms
Chapter VI - Forms For Use In Courts Exercising Criminal Jurisdiction
Form 15 - Elimination or relaxation of conditions of probation

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

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

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

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________

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