New York State Division of Probation and Correctional Alternatives by wqs99947

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									                                  New York State Division of Probation and Correctional Alternatives
                                       New York State Division of Criminal Justice Services
    ENTRY                                                                                                                         MODIFY
                                         Integrated Probation Registrant System (IPRS)
                                                   Probation Violation Form
                                                          *REQUIRED FIELDS




*Registration # ____________________________________________________________________________________

*Probationer Name_________________________________________________________________________________




*Date Violation Filed:                                               Violation Reasons             Pick 1 Violation Reason that is applicable


                                                                             Technical Arrest                New Conviction
Disposition Date:
                                                                                  Absconded                  Other Technical
 Dispositions Recommended by Probation
                                                                  Dispositions From Court        Pick 1 Disposition that is applicable
 Pick 1 Disposition that is applicable

                  Continue                      Modify                                   Continue                        Modify
                    Revoke                    Discharge                                   Revoke                     Discharge
                Withdraw                           ISP                                    Dismiss                           ISP
Revoke and Jail/Probation                        Other                 Revoke and Jail/Probation                         Other


                                                                        Resentenced             Pick all Resentence options that are applicable


                                                                                      State Prison                     Local Jail

                                                                      Juvenile Facility Placement                      Probation
                                                                       Intermittent Imprisonment                            Fine
                                                                         Unconditional Discharge




 *Delinquency Declared:                                           Date Delinquency Filed by Probation:

                YES                                                                      New ME Date:
                  NO
          PENDING


Date Delinquency Approved By Court:



Date Warrant Issued:                                                        Date Warrant Disposed of:




                                                                                                                   Date Last Revised: 8/01/05

								
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