New York Codes, Rules and Regulations
Title 22 - JUDICIARY
Subtitle D - Forms
Chapter VI - Forms For Use In Courts Exercising Criminal Jurisdiction
Form 16-c - Designation of psychiatric examiners

C.P.L. Article 730

FORM 16-c

12/88

DESIGNATION OF PSYCHIATRIC EXAMINERS

________ COURT OF ________

COUNTY OF ________

________x

PEOPLE OF THE STATE OF NEW YORK, DESIGNATION OF

PSYCHIATRIC

- against - EXAMINERS

Docket No. ________

________ Indictment No. ________

Defendant.

________x

The undersigned, having been directed by order signed by Honorable ________, (Judge) (Justice) of the ________ Court of ________ County, dated ________, to examine the above named defendant pursuant to Article 730 of the Criminal Procedure Law, does hereby designate ________, a qualified psychiatrist and ________ (a qualified psychiatrist) (a qualified psychologist) for the purpose of conducting the examination of said defendant, each to make a separate report of said examination.

Dated: ________

______________

Signature

______________

Printed Name

Director of Community Mental

Health Services, ____________ County

Director ____________ Hospital