CIRCUIT COURTDISTRICT COURT OF MARYLAND FORCity/CountyLocated atCourt AddressSTATE OF MARYLANDvs.DefendantPROBATION/SUPERVISION ORDERAlternative Community Service:Probation Before Judgment (Criminal Procedure Article 247 6-220)Be UnsupervisedDrinking Driving Monitor Program onlyParole and ProbationSexualCC-DC-026 (Rev. 10/2017)Page 1 of 4(IF AVAILABLE, PLACE LABEL HERE OR AT TOP OF PAGE.)Tracking NumberCase No.Convicted Count(s):Sentence:Part of Sentence Executed:Credit for Time Served:Suspended:IT IS ORDERED THAT the above named Defendant:Be Supervised by:Other:Length of Probation:mo/yr(s)Balance of sentence suspended upon admissionto treatment pursuant to HG 247 8-507upon admission to residentialsubstance abuse program.onSID No.Probation beginsLifetime Sexual Offender Supervision by Management TeamOffender Management TeamYour first appointment with the supervising agency is and the place to report to is Your failure to report could result in your arrest.A. Standard Conditions: All Standard Conditions All Standard Conditions except Nos. 1. Report as directed and follow your supervising agent's lawful instructions. 2. Work and/or attend school regularly as directed and provide verification to your supervising agent. 3. Get permission from your supervising agent before: changing your home address, changing your job, and/or leaving the State of Maryland. 4. Obey all laws. 5. Notify your supervising agent at once if charged with a criminal offense, including jailable traffic offenses. 6. Get permission from the court before owning, possessing, using, or having under your control any dangerous weapon or firearm of any description. 7. Permit your supervising agent to visit your home. 8. Do not illegally possess, use, or sell any narcotic drug, controlled substance, counterfeit substance, or related paraphernalia. 9. Appear in court when notified to do so. American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 4CC-DC-026 (Rev. 10/2017)10.Pay all fines, costs, restitution, and fees as ordered by the court or as directed by your supervising agentthrough a payment schedule.Case No.Fine(s) of $Parole and Probationpaid throughClerk's OfficeSheriff's OfficeCourt costs of $Clerk's Officepaid throughSupervision fee of $50/month paid through Parole and ProbationSupervision fee waivedRestitution of $ topaid through Parole and Probation State's Attorney's Office by (Date)Public Defender fees of $ to the Office of the Public Defender for counsel fees.Pay the following fees through Parole and Probation orVictims of Crime FundCICF costsOther costs (Specify)The Division of Parole and Probation is hereby granted the discretion to refer the collection of funds itis authorized to collect to the State's Central Collection Unit without the need of further court approval.Special Conditions:B.$$$Parole and Probation11.Provide DNA sample as required by law by (Date)13.Submit to, successfully complete, and pay required costs for alcohol drug alcohol and drug evaluation testing treatment education, as directed by your supervising agent.14.Attend self-help group meetings per week for weeks. Attendance may bemodified by your supervising agent after weeks.15.Attend and successfully complete alcohol drug alcohol and drug treatment education program16.Totally abstain from alcohol, illegal substances, and abusive use of any prescription drug.17.Apply for alcohol restriction on driver's license within 10 days of trial date for year(s)/month(s).18.Refrain from driving and/or attempting to drive after consuming alcohol.19.Attend Victim Impact Panel meetings when notified.20.Attend and successfully complete MVA Driver Improvement Program.21.Have Ignition Interlock installed for months and pay costs. Employment vehicleexempted.22.Submit to evaluation and attend and successfully complete mental health treatment as directed by yoursupervising agent.23.Attend and successfully complete Special Health Education Program - Project SASOE24.Attend and successfully complete parenting class.12.Submit to and pay for random urinalysis as directed by supervising agent. American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 433.OtherCC-DC-026 (Rev. 10/2017)Case No.25.Completehours of community service by(Date), under the direction ofand pay required fees.26.Enroll in, pay any required costs for, and successfully complete treatment at27.Attend and successfully complete domestic violence counseling atby(Date) and pay required costs.28.Have no contact with29.Do not enter or be found near30.Home confinement/detention toformonthsSpecial conditions (e.g. doctor's appointments, attending classes, etc.)31.Register as sexual offender with the supervising authority under the provisions of Criminal ProcedureArticle, Title 11, Subtitle 7:(1)A Tier I Sex Offender;(2)A Tier II Sex Offender;(3)A Tier III Sex Offender;(4)A sexually violent predator;(5)A Tier I Sex Offender who, before moving into this State, was required toregister in another State;(6)A Tier II Sex Offender, Tier III Sex Offender, or sexually violent predator who,before moving into this State, was required to register in another State;(7)A Tier I, Tier II, Tier III Sex Offender, or a Sex Offender who is required to register inanother State, Jurisdiction, a federal, military, or tribal court, or a foreign government, who isnot a resident of this State, and who enters this State:(i)(ii)(iii) (iv)To reside or habitually live.To carry on employment or vocation that is full-time or part-time fora period exceeding 14 days or for an aggregate period exceeding 30 days during acalendar year, whether financially compensated, volunteered, or for the purpose ofgovernment or educational benefit; orTo attend a public or private educational institution, including a secondary school,trade or professional institution, or institution of higher education, as a full-time orpart-time student.As a transient with the intent to be in the State for a period exceeding 14 days or anaggregate period exceeding 30 days during the calendar year.....32.Electronic monitoringElectronic monitoring with stay-away alert technology American LegalNet, Inc. www.FormsWorkFlow.com Page 4 of 4Recommendations to the supervising agency:D.35.Transfer supervision toCounty/City, State of MarylandState under the Interstate Compact36.Judge:Date:CONSENT I have read, or have had read to me, the above conditions of probation. I understand these conditions and agree tofollow them. I understand that if I do not follow these conditions, I could be returned to court charged with aviolation of probation. If I fail to abide by the above conditions, the court could enter judgment against me and proceed with dispositionas if I had not been placed under probation. I have been notified and understand that by consenting to and receivinga stay of judgment under Criminal Procedure Article, 247 6-220, I waive my right to appeal from a judgment of guiltyby the court in this case. I understand that my failure to comply with Condition 10 may result in my case being referred to the State'sCentral Collection Unit, resulting in an additional collection fee as permitted by law. I understand that Parole and Probation may impose Graduated Sanctions upon me for any technical violation ofthe above conditions of probation, as authorized pursuant to Correctional Services Article, 247247 6-111 and 6-121.Defendant's SignatureDateDate of BirthDefendant's AddressWitness' Signature37.OtherDefendant shall keep appointment for HG 247 8-505 evaluation and shall immediately enter therecommended program upon admission.Defendant shall enter treatment program immediately upon admission.Defendant shall successfully complete treatment program and comply with terms of aftercare plan.C.34.Comply with special conditions of lifetime supervision - see form #CC-DC-CR-136.Case No.CC-DC-026 (Rev. 10/2017) American LegalNet, Inc. www.FormsWorkFlow.com