Proof Of Enrollment Or Completion Alcohol Or Drug Program
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Proof Of Enrollment Or Completion Alcohol Or Drug Program Form. This is a California form and can be use in Miscellaneous Judicial Council.
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Tags: Proof Of Enrollment Or Completion Alcohol Or Drug Program, MC-400, California Judicial Council, Miscellaneous
FOR COURT USE ONLY
NAME AND ADDRESS OF COURT:
NAME OF DEFENDANT:
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
DATE OF COURT ORDER:
(check one)
PROOF OF ENROLLMENT IN ALCOHOL OR DRUG PROGRAM
CASE NUMBER:
PROOF OF COMPLETION OF ALCOHOL OR DRUG PROGRAM
DESCRIPTION OF ALCOHOL OR DRUG PROGRAM
Name of Program:
Address of Program:
Program License Number:
Program Telephone Number:
PROOF OF ENROLLMENT
1. Defendant (name):
enrolled in the alcohol or drug
education program described above on (specify date of enrollment):
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
................................................................................................
(TYPE OR PRINT NAME)
(SIGNATURE OF DEFENDANT)
(TYPE OR PRINT NAME)
(SIGNATURE OF PROGRAM DIRECTOR OR INSTRUCTOR)
Date:
(TITLE)
PROOF OF COMPLETION
successfully completed the alcohol or drug
2. Defendant (name):
education program described above on (specify date of completion):
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
................................................................................................
(SIGNATURE OF DEFENDANT)
(TYPE OR PRINT NAME)
Date:
................................................................................................
(TYPE OR PRINT NAME)
(SIGNATURE OF PROGRAM DIRECTOR OR INSTRUCTOR)
(TITLE)
— INSTRUCTIONS —
YOU NEED TWO OF THESE FORMS:
1. UPON ENROLLMENT IN A COURT-ORDERED ALCOHOL OR DRUG EDUCATION PROGRAM, FILL OUT THE PROOF OF
ENROLLMENT PORTION OF ONE COPY OF THIS FORM AND FURNISH IT TO THE SENTENCING COURT WITHIN THE TIME AND IN
THE MANNER SPECIFIED BY THE COURT.
2. UPON SUCCESSFUL COMPLETION OF THE PROGRAM, FILL OUT THE PROOF OF COMPLETION PORTION OF A SECOND COPY OF
THIS FORM AND FURNISH IT TO THE SENTENCING COURT WITHIN THE TIME AND IN THE MANNER SPECIFIED BY THE COURT.
FAILURE TO COMPLY WITH THESE REQUIREMENTS MAY RESULT IN THE REVOCATION OF YOUR PROBATION.
Sl USTED NO CUMPLE CON ESTOS REQUISITOS, SU INCUMPLIMIENTO PUEDE RESULTAR EN LA REVOCACION DE SU LIBERTAD
CONDICIONAL.
Form Approved by the
Judicial Council of California
MC-400 [Rev. January 1, 1986]
PROOF OF ENROLLMENT OR COMPLETION
ALCOHOL OR DRUG PROGRAM
Veh. Code, §23205
2001 © American LegalNet, Inc.
