N.Y. Comp. Codes R. & Regs. tit. 22, subtit. D, ch. II, Forms (cf. Part 110), form G
FORM G
COMMITMENT ORDER
STATE OF NEW YORK
SUPREME COURT COUNTY COURT
PART: ________ COUNTY: ____________
________
PEOPLE OF THE STATE OF NEW YORK
Indictment No. ____________
vs. Crime Charged:
________
Defendant
________
Present:
Honorable ____________
Justice of the Supreme Court
Judge of the County Court
The above-named defendant having been found not responsible by reason of mental disease or defect by verdict (C PL 300.10, subd. 4[d])
by plea (C PL 220.15)
And, this court having issued an examination order on [date] ________ pursuant to the provisions of subdivision 2 of C PL 330.20 requiring that the above-named defendant submit to a psychiatric examination to determine whether the said defendant has a dangerous mental disorder,
And, the Commissioner of Mental Health having submitted to this court the examination reports required by subdivision 5 of C PL 330.20,
And, the court having conducted the initial hearing required by subdivision 6 of C PL 330.20 to determine the present mental condition of the above-named defendant,
And, due deliberation thereon having been had, and upon reading and filing the decision of the court,
And, the court having found that the above-named defendant currently suffers from a dangerous mental disorder, as that term is defined in paragraph (c) of subdivision 1 of C PL 330.20,
It is hereby
ORDERED that the above-named defendant is committed to the custody of the Commissioner of Mental Health for confinement in a secure facility to be designated by the said Commissioner for care and treatment for six months from the date of this order and it is further
ORDERED that the
Commissioner of Correction for the City of New York
Sheriff of ________ County
Commissioner of Correction for ________
shall hold the above-named defendant in custody pending the aforesaid designation by the State Commissioner of Mental Health and when notified of the designation shall promptly deliver the said defendant to such facility.
Dated: ________
____________
Justice of the Supreme Court
Judge of the County Court
Designation of Secure Facility:
The State Commissioner of Mental Health has designated the following secure facility referred to in this order as the place for the confinement of the above-named defendant:
____________
The authority for designating the above-named secure facility is: ____________
____________.
N.Y. Comp. Codes R. & Regs. tit. 22, subtit. D, ch. II, Forms (cf. Part 110), form G