N.Y. Comp. Codes R. & Regs. tit. 22, subtit. D, ch. VI, form 14a
Sec. 410.20, 410.40 C.P.L. FORM 14a
(Enlargement of
Conditions of Probation)
1/87
ENLARGEMENT OF 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
[County] Department of
Probation requests the Court to order probationer personally to appear before the Court at the time and place set forth below, so that the Court may entertain the Department's request that probationer's conditions of probation be enlarged as follows ____________
____________
____________
____________
______________
(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________
N.Y. Comp. Codes R. & Regs. tit. 22, subtit. D, ch. VI, form 14a