Juvenile Justice Planning Survey
                             Secure Holding of Juveniles by Police
                              Planning for Implementation of P.A. 07-04

This survey will gather information from police agencies concerning the secure holding of juveniles,
and youth ages 16 and 17. The information collected will be summarized and presented to the Juvenile
Justice Planning and Operations Council, which is charged with overseeing the implementation of P.A.
07-04, the act that mandates 16 and 17 year olds be handled as juveniles beginning in January 2010.

The first part of the survey is to implement data collection procedures for the month of May 2008 on
your department’s handling of persons aged 16 and 17. Please collect the following data on each 16 or
17 year old arrested and brought to the police station in May.

           a.   Date
           b.   Incident/Case Number
           c.   Offender’s Initials
           d.   Birth Date
           e.   Most Serious Offense
           f.   Whether They Were Held Securely
           g.   Where They Were Held Securely
           h.   Date and Time Admitted to Secure Location within the Station
           i.   Date and Time Discharged from the Station
           j.   Type of Discharge

See the format for this data collection.

When the data collection is complete, copy each page and send, by regular mail, to:

Gary Lukasewski
Office of Policy and Management
450 Capitol Avenue
Hartford, CT 06106-1379.

Call Gary with any questions at 860-418-6320. Keep the original for your records.

The second part of our survey will be distributed in early June and will require your review of this data
on 16 & 17 year olds.
Department Name:                                                                                                   Page:

                                   POLICE DEPARTMENT INFORMATIONAL SURVEY FOR PUBLIC ACT #07-04
Please provide the following information on every offender under arrest who was age 16 & 17 and brought to your police station during the month of May 2008. Use additional copies
of this form as necessary and number each page. In early June, copy each page and send, by regular mail, to Gary Lukasewski, Office of Policy and Management, 450 Capitol Avenue, Hartford,
CT 06106-1379. Call Gary with any questions at 860-418-6320.

              Incident/     Offender       Birth         Most Seri-                   Secure         Where                 Date/Time            Date/Time             Type of
Date          Case #        Initials       Date          ous Offense                  Holding        Held*                 Admitted             Discharged            Discharge*

Where Held:        Lockup/Cellblock, Holding Cage, Detention Room, Interview Room, Detective Bureau, Investigation Office, Youth Division, Other (explain).
Type of Discharge: Promise to Appear (PTA), Bond, Held for Court, Other (explain).

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