State of New York County of Westchester Orders and Conditions of Adult Probation 12950872Q Ind. /Docket No: County of Westchester Order and Conditions of Probation People of the State of New York Against The above named defendant having been convicted of_ or Q adjudicated a youthful offender is hereby sentenced to a expire on_ condition of Probation a to pay a fine in the amount of $_ directly to the Court. year term of Probation to unless terminated by the Court prior to the aforementioned date. As a _ term of imprisonment is imposed. The defendant is also ordered _ and a penalty assessment in the amount of While on probation, said defendant is ORDERED to comply with the following conditions and any others which the Court may impose at a later date. General Conditions: 1. Report to a Probation Officer as directed by the Probation Officer and permit the Probation Officer to visit you at your home or elsewhere. 2. Remain within the jurisdiction of the Court unless granted permission to leave by the Court or the Probation Officer. 3. Obey the directions given by the Court or the Probation Officer 4. Answer all reasonable inquiries by the Probation Officer and notify the Probation Officer prior to any change in address or employment. 5. Do not violate any state, federal, local law or vehicle and traffic laws in any jurisdiction. 6. Notify your probation officer immediately, but no later than 1business day, if questioned or arrested by any law enforcement personnel.
12950872Q 7. Avoid injurious or vicious habits, refrain from frequenting unlawful or disreputable places and refrain from consorting with disreputable persons. 8. Work faithfully at a suitable employment or pursue a course of study or vocational training that can lead to a suitable employment. 9. Submit to any examination or evaluation directed by the Probation Officer and take part in such treatment and counseling, including medical, psychiatric or residential treatment, as may be required by the Probation Officer until successful completion of said program. 10. Promptly provide an appropriate sample as directed by the Probation Officer for DNA testing pursuant to Section 995-C (3) of the New York State Executive Law. 11. Permit a Probation Officer to conduct searches of your person, your place of residence, or other real or personal property within your control, including your vehicle. 12. Support your dependents and meet other family responsibilities. 13. Abstain from the use of any drug not prescribed by a physician. 14. Refrain from the consumption or possession of alcoholic beverages 15. Submit to random alcohol or drug testing when ordered by the Probation Officer. Undergo an alcohol and or drug abuse evaluation at a licensed treatment agency and participate in treatment if so recommended, including both in-patient and out-patient programs and remain in said facility or program until successful completion including all aftercare recommendations. 16. Perform and complete_ hours of Community Service as directed by the Court to commence at the direction of the Probation Officer. 17. You shall not possess or own concealed bladed instruments, firearms or simulated firearms, ammunition, or any dangerous weapons, including but not limited to those defined in section 265.00 of the N.Y.S. Penal Code, without express permission of the court. 18. Pursuant to Article 720.35 (sub 2) (youthful Offender) of the CPL, the Court authorizes the exchange of information to the appropriate agencies. 19. You shall abide by such curfew as directed by your Probation Officer and shall be at your residence at the hours established in your curfew. 20. You shall make restitution in the amount of $_ plus a 10% surcharge to the Westchester County Probation Department, (attach restitution order) 21. Shall be prohibited from belonging to any gang, associating with any gang members and participating in any gang activity including the wearing of gang clothing, insignias, signs and or paraphernalia 22. Other:_ 2
Domestic Violence Conditions: 12950872Q 1. You shall observe the conditions of conduct as set forth in any Order of Protection issued by a Court of competent jurisdiction. 2. You shall refrain from intimidating or harassing the victim(s) and shall not do so through a third person. This prohibited conduct shall include communication with a third person intended to be overheard by the victim(s), with the intent to harass, annoy, or alarm that victim. This prohibited conduct shall also include disparaging the victim through electronic media or disseminating information regarding the victim(s) or any photograph of the victim(s), with the intent to harass, harm, embarrass, or intimidate the victim(s). This conduct shall be prohibited regardless of whether the photograph disseminated has been provided to you by the victim(s). 3. You shall refrain from accessing the victims email, mail, or recorded messages;gathering information about the victim through search engines and/or public profiles;gathering information about the victim through search engines and/or public profiles; impersonating anyone through electronic media or otherwise; installing "Spyware" or any product that accomplishes the same result, on any computer, phone, or electronic device; enabling or installing any Geo-location device or GPS on anyone s phone, computer, or car, unless it is a device used exclusively by you; accessing recorded data from any GPS device, phone, computer, navigation system, or "On-Star" service, unless it relates to a device used exclusively by you; installing or using any application that makes it possible to disguise your telephone number,voice, or identity, i.e., "spoofing." 4. You shall refrain from communicating with the victim(s) in any form unless authorized to do so, or given prior permission by the Court. 5. You shall sign a release authorizing disclosure of information regarding your participation in any and all treatment, educational, or batterers' classes required to be attended pursuant to this Order, to the Court, the Department of Probation, or any other agency authorized by the Court. 6. If you are required to possess or use a firearm in connection with your employment, you must immediately notify your employer that you have been convicted of a domestic violence related offense and surrender to your employer all firearms issued to you in connection with your employment in accordance with applicable law. 7. You are not to reside in any location in which someone owns or possesses any firearm, legally or otherwise, unless given permission by the Probation Department or the Court. 8. If given permission to reside with someone who owns or possesses a legal firearm, you must notify the person you reside with that you are prohibited from owning or possessing a firearm, and that if they own or possess any firearm, that they are to take immediate measures to safeguard same in accordance with Penal Law Section 265.45. You will immediately notify your probation officer when you have complied with this provision and your probation officer may contact those parties directly to confirm same. 9. You must notify any person that you may engage with in a dating or intimate relationship, of your domestic violence related offense(s). 3
12950872Q Probation Case#: CCF-2016-5086 10. You must not cohabit with any person with who you are having an intimate relationship unless granted permission by your Probation Officer. 11. Your Probation Officer may discuss your offense with any person he or she feels is appropriate in the interest of your rehabilitation or the protection of the public. 12. You are not to possess or apply for any hunting license or pistol permit from any jurisdiction. 13. You must notify your Probation Officer within 48 hours of any proceeding commenced in any Family or Supreme Court which relates to any victim(s), in which you have been served with a petition/notice, or have otherwise appeared. If you are the party filing the petition in a Family or Supreme Court, you must notify your Probation Officer within 24 hours of filing the petition. 14. You must provide a copy of any order issued subsequent to the date of the issuance of these conditions, by the Family Court, Criminal Court, or Supreme Court, of any competent jurisdiction, that relates to you and the victim(s), to your probation officer within five business days from your receipt of same. 15. You must notify your Probation Officer within 48 hrs. if you have been advised by any child protective agency, that you are the subject of an inquiry or investigation. 16. You are required to submit to periodic searches by the Probation Officer (or designee), of your computer/electronic device/telephone or any computer/electronic devise/telephone within your control. These devices may be seized by the Probation Department if any evidence is found that they have been used in violation of any conditions of probation or in furtherance of same. 17. You must enter into and/or participate in any domestic violence or batterers' educational course deemed necessary and sanctioned by the Probation Department and remain therein. You are to make the necessary financial arrangements to pay for such courses/services. 18. If deemed appropriate by the Probation Department, you are to attend meetings of any alcoholic/narcotic self-help group approved by the Probation Department and provide verification of participation 19. Submit to a hair follicle analysis as directed by the Department of Probation or the Court at your expense. 4
For Court Use Only'. 12950872Q Additional Conditions of Probation ordered by the Court: fpleaseindicate noneifno additional conditions are ordered) Dated: Honorable: 5
12950872Q Probation Case#: CCF-2016-5086 ADVISEMENT TO THE DEFENDANT You must report immediately upon release from custody or after sentencing to the Westchester County Probation Department located at 111Dr. Martin Luther King Jr. Blvd 7th Floor, White Plains, New York 10601. Your failure to conform to any of the imposed conditions of Probation, including failure to report to your probation officer is a violation of probation. You have the right to be present at any hearing to determine whether a violation of probation has occurred. If you intentionally absent yourself from the Court of jurisdiction or intentionally fail to appear at a violation of probation hearing, the hearing can be held in your absence which may result in a revocation of your probation sentence. Receipt: I have this day received a copy of the foregoing Conditions of Probation Probationer: Address: Date: Witness: Court Clerk 6