þ The State of MichiganTHE PEOPLE OF þ þ en-US en-US þ þ en-USven-USDefendant222s name, address, and telephone no.en-USCTN/TCNen-USSIDen-USDOB Probation officerOffense and PACCTerm Judgment of guilt is deferred* under: þ MCL 333.7411, Controlled Substance Act þ MCL 750.350a, Parental Kidnapping Act þ MCL 762.14, Youthful Trainee Status MCL 600.1070, Drug Treatment Court þ MCL 600.1095, Mental Health Court þ MCL 600.1206, Veterans Court þ Under 18 USC 922(g)(8), the court found, at a hearing, that the defendant represents a credible threat to the physical þ safety þ of one or more persons as defined in 18 USC 922(g)(8) and 18 USC 921(a)(32) and named in item 9. **Needed for NCIC entry.IT IS ORDERED that the defendant be placed on probation under the supervision of the probation officer named above for the term indicated, and the defendant shall: 1. þ Not violate any criminal law of any unit of government. 2. þ Not leave the state without the consent of this court. 3. þ Make a truthful report to the probation officer monthly, or as often as the probation officer may require, either in person or in þ writing, as required by the probation officer. 4. þ Notify the probation officer immediately of any change of address or employment status. þ 5. þ Not purchase or possess a firearm. (**Needed for NCIC entry.) 6. þ Pay the following to the court: þ Crime Victim Assessment.... þ $ þ Fines...................................................... þ $ þ Restitution............................ þ $ þ Costs..................................................... þ $ þ State Minimum Costs........... þ $ þ Other (including any DNA assessment.. þ $ þ þ Total....................................................... þ $ þ þ a. þ The due date for payment is . þ þ b. þ The total amount due shall be paid in installments of $ per starting on Date þ and paid in full by the due date stated in the judgment of sentence or by . þ Fines, costs, and fees not paid within 56 days of the date owed or of any installment payment date are subject to a 20% late þ penalty on the amount owed. 7. þ Pay a supervision fee to the Department of Corrections in the amount of $ . The fee is payable immediately. þ þ The total amount due may be paid in installments of $ per starting on Date þ payable to the State of Michigan. þ 8. þ Comply with the attached wage assignment order. þ 9. þ Other: (Use this space for conditions for the protection of one or more named persons - also complete the LEIN order on Part 2 of this form. See þ back of form for required language when conditions are ordered pursuant to 18 USC 922[g][8].)Failure to comply with this order may result in a revocation of probation and incarceration. If you are not able to pay due to financial hardship, contact the court immediately to request a payment alternative. MCR 6.425(E)(3). Date þ Judge Bar no.en-USI have read or heard the above order of probation and have received a copy. I understand and agree to comply with this order. I also understand en-USthat federal and/or state law may prohibit me from possessing or purchasing ammunition or a firearm (including a rifle, pistol, or revolver) if en-USthe court found I represent a credible threat to the physical safety of a named person and/or explicitly prohibited (in item 9) the use, attempted en-USuse, or threatened use of physical force that would reasonably be expected to cause bodily injury to that named person. en-USDate þ en-USDefendant signatureen-USIf the judgment of guilt is deferred as stated above, the clerk of the court shall advise the Michigan State Police Criminal Justice Information Center of the en-USdisposition as required under MCL 769.16a. A case in which judgment of guilt is deferred shall be maintained as a nonpublic record. *If the judgment of guilt is en-USdeferred and the defendant is incarcerated, the clerk of the court should also advise the incarcerating agency of nonpublic record status. en-US en-US1en-USMCL 600.4803, MCL 769.1a, MCL 771.1 en-USet seqen-US., MCL 775.22, MCL 780.826,en-USMCR 6.445, 18 USC 922(g)(8) American LegalNet, Inc. www.FormsWorkFlow.com þ The State of MichiganTHE PEOPLE OF þ þ en-US en-US þ þ en-USven-USDefendant222s name, address, and telephone no.en-USCTN/TCNen-USSIDen-USDOB Probation officerOffense and PACCTerm Judgment of guilt is deferred* under: þ MCL 333.7411, Controlled Substance Act þ MCL 750.350a, Parental Kidnapping Act þ MCL 762.14, Youthful Trainee Status MCL 600.1070, Drug Treatment Court þ MCL 600.1095, Mental Health Court þ MCL 600.1206, Veterans Court þ Under 18 USC 922(g)(8), the court found, at a hearing, that the defendant represents a credible threat to the physical þ safety þ of one or more persons as defined in 18 USC 922(g)(8) and 18 USC 921(a)(32) and named in item 9. **Needed for NCIC entry.IT IS ORDERED that the defendant be placed on probation under the supervision of the probation officer named above for the term indicated, and the defendant shall: 1. þ Not violate any criminal law of any unit of government. 2. þ Not leave the state without the consent of this court. 3. þ Make a truthful report to the probation officer monthly, or as often as the probation officer may require, either in person or in þ writing, as required by the probation officer. 4. þ Notify the probation officer immediately of any change of address or employment status. þ 5. þ Not purchase or possess a firearm. (**Needed for NCIC entry.) 6. þ Pay the following to the court: þ Crime Victim Assessment.... þ $ þ Fines...................................................... þ $ þ Restitution............................ þ $ þ Costs..................................................... þ $ þ State Minimum Costs........... þ $ þ Other (including any DNA assessment.. þ $ þ þ Total....................................................... þ $ þ þ a. þ The due date for payment is . þ þ b. þ The total amount due shall be paid in installments of $ per starting on Date þ and paid in full by the due date stated in the judgment of sentence or by . þ Fines, costs, and fees not paid within 56 days of the date owed or of any installment payment date are subject to a 20% late þ penalty on the amount owed. 7. þ Pay a supervision fee to the Department of Corrections in the amount of $ . The fee is payable immediately. þ þ The total amount due may be paid in installments of $ per starting on Date þ payable to the State of Michigan. þ 8. þ Comply with the attached wage assignment order. þ 9. þ Other: (Use this space for conditions for the protection of one or more named persons - also complete the LEIN order on Part 2 of this form. See þ back of form for required language when conditions are ordered pursuant to 18 USC 922[g][8].)Failure to comply with this order may result in a revocation of probation and incarceration. If you are not able to pay due to financial hardship, contact the court immediately to request a payment alternative. MCR 6.425(E)(3). Date þ Judge Bar no.en-USTO LOCAL LAW ENFORCEMENT:en-US The protective conditions in item 9 and the following identifying information of the defendant en-USmust be entered on the LEIN system. The court will notify local law enforcement of any amendments to or revocation of this en-USorder. en-USHeighten-USWeighten-USRaceen-USSexen-USDate of Birthen-USHair Coloren-USEye Coloren-USOther Identifying Information en-USEffective date of conditions in item 9 þ en-USExpiration date of order en-USDate þ en-USJudge/Magistrate Bar no.en-US2 American LegalNet, Inc. www.FormsWorkFlow.com Required Language When Conditions are Issued Pursuant to 18 USC 922(g)(8):Use the following language when the conditions involve an intimate partner of the defendant or child of the intimate partner or defendant as defined in 18 USC 922(g)(8) and 18 USC 921(a)(32). Defendant is restrained from harassing, stalking, or threatening, or engaging in other conduct that would place [insert name(s)] in reasonable fear of bodily injury.For details about these conditions, see SCAO Administrative Memorandum 2008-02. American LegalNet, Inc. www.FormsWorkFlow.com