New York Codes, Rules and Regulations
Title 22 - JUDICIARY
Subtitle D - Forms
Chapter VI - Forms For Use In Courts Exercising Criminal Jurisdiction
Form 16-m - Certification of custody

C.P.L. Article 730

FORM 16-m

12/88

CERTIFICATION OF CUSTODY

________ COURT OF ________

COUNTY OF ________

________x

PEOPLE OF THE STATE OF NEW YORK, CERTIFICATE OF CUSTODY

Docket No. ________

Indictment No. ________

-against-

________,

Defendant.

________ x

TO: The above named court

TO: District Attorney, ________ County

This is to certify that the above-named defendant who was committed to my custody or ordered retained in my custody by (a temporary order of observation) (the last order of retention), dated ________, 19 ________, was in my custody on the expiration date of such order.

Dated: ________

_________

Signature of Director

_________

Printed Name

_________

Facility