Monroe County Probation Department 43 rd Judicial District Box 777, Court House Stroudsburg, PA 18360
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1 Monroe County Probation Department 43 rd Judicial District Box 777, Court House Stroudsburg, PA Steven A. Houloose Adult Probation (570) Chief Probation Officer Juvenil.e Probation (570) TO WHOM IT MAY CONCERN FROM Steven A. Houloose, Chief Probation Officer of Monroe County DATE December 8, 2008 form. Attached is an amended copy of the Work Release Petition. Please start using this new Thank you for your cooperation. Steven A. Houloose Chief Probation Officer SAH/ccb
2 COURT OF COMMON PLEAS OF MONROE COUNTY 43RD JUDICIAL DISTRICT COMMONWEALTH OF PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA NO. VS. CHARGE ORDER OF COURT AND NOW, this day of, 200, upon consideration of the within Petition for Work Release, the Court determines the defendant to be Work Release Eligible subject to the following to leave the Jail for the purpose of participating in the Work Release Program at, whose address is, and would work from.m. to.m. daily, through, leaving the Jail at.m. and returning at.m., at the rate of $. Transportation will be provided by. In accordance with the request, the wages and salary of the said shall be disbursed as follows (1) That a $25.00 administrative processing fee be withdrawn from the first paycheck to defray the cost of urinalysis testing. The fee will be made payable to the County of Monroe and will be credited toward the prisoner supply line item of the Monroe County Correctional Facility Budget.
3 (2) That board be paid to David Mauro, Warden of Monroe County Correctional Facility in the amount of $ per week which is the normal rate for prisoners. (3) That he/she be granted necessary travel and incidental expenses to and from work in the amount of $ per week. (4) That $ be paid to the Clerk of Courts on fines, costs, and/or restitution every pay period. (5) That $ be paid toward support pursuant to any existing Court Orders. (6) That the balance of the money remaining to be paid to David Mauro, Warden, as escrow agent, or, designee. (7) That his/her employer mail his/her check directly to David Mauro, Warden, Monroe County Correctional Facility, 4250 Manor Drive, Stroudsburg, Pennsylvania (8) That revocation or modification of this Order by jail officials shall be compliance with 42PA C.S.A. 9813(c) with written notification to the Probation Department. (9) That this Order may be modified or revoked at any time by the Court with notice to the defendant. BY THE COURT CC Probation Department Defense Counsel District Attorney Monroe County Correctional Facility Defendant P.J.
4 COURT OF COMMON PLEAS OF MONROE COUNTY 43RD JUDICIAL DISTRICT COMMONWEALTH OF PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA NO. VS. CHARGE PETITION FOR WORK RELEASE TO THE HONORABLE, THE JUDGES OF SAID COURT The Petition of respectfully represents 1. The Petitioner is, the above captioned defendant, presently incarcerated in County Correctional Facility. 2. Defendant was sentenced by on to serve for. 3. The Defendant has employment with located at earning gross wages in the amount of $ per hour/per week. 4. The hours of employment are from.m. to.m. daily, through. 5. Transportation to and from work will be provided by.
5 6., Defendant above named, hereby respectfully requests that Your Honorable Court issue an Order pursuant to this Petition for Work Release and that wages be disbursed as follows (a) That a $25.00 Administrative Processing Fee be withdrawn from the first paycheck to defray the cost of urinalysis testing. The fee will be made payable to the County of Monroe and will be credited toward the prisoner supply line item of the Monroe County Correctional Facility Budget. (b) That board be paid to the County of Monroe in the amount of $, which is the normal rate for prisoners. (c) That necessary travel and incidental expenses to and from work in the amount of $ per week be granted. (d) That $ be paid to the Clerk of Courts on fines, costs, and/or restitution every pay period. (e) That $ be paid toward support pursuant to any existing Court Orders. (f) That the balance of money remaining be paid to. (g) That the Defendant's employer mail the check directly to David Mauro, Warden of Monroe County Correctional Facility. 7. Attached hereto and marked Exhibit "A" is a Verification by the Probation Office that the information is correct. WHEREFORE, Petitioner requests this Honorable Court to grant work release under the terms and conditions set forth in this Petition. Attorney for Petitioner
6 VERIFICATION I,, verify that the facts set forth in the within Petition for Work Release, are true and correct to the best of my knowledge, information, and belief. I understand that the statements made herein are subject to the penalties of l8 Pa. C.S.A. subsection 4904 relating to unsworn falsification to authorities. Petitioner The District Attorney has received notice that the defendant petitions to be work release eligible, has met the contact requirement for registered crime victim input, and has no opposition to the defendant being work release eligible. District Attorney
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