PROBATION/CONDITIONAL DISCHARGE MOTION JD-CR-59 Rev. 11-14 C.G.S. §§ 53a-29, 30, 31, 32, 33, 34 P.B. §§ 43-29, 43-29A STATE OF CONNECTICUT SUPERIOR COURT www.jud.ct.gov Not For Use By Probation/CSSD. Instructions To Filer 1. File one form per case (docket number). 2. File original and one copy with the Clerk 3. Serve one copy on probation officer. 4. Retain a copy for your records. Probation Conditional Discharge Filed as a motion for ("X" one) Modification of Conditions Termination Revocation of Conditional Discharge Docket number Name of defendant ADA NOTICE The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act (ADA). If you need a reasonable accommodation in accordance with the ADA, contact a court clerk or an ADA contact person listed at www.jud.ct.gov/ADA. Instructions To Clerk Upon Judgment: Distribute a copy of the judgment to CSSD/Adult Probation and file the original in the day's business under the date of this order. Geographical Area Number/Judicial District Place of sentencing Defendant's Current Address (Number, Street, Apartment Number, Town, and ZIP Code) Original charge(s) for which the defendant was sentenced Original offense date Original sentence (Include any suspended portion and period of probation) Date of sentencing Name of Judge -- original order probation/conditional discharge Date of original order Defendant in custody Yes Reason for motion No If motion for modification or termination specify request Signed (Filer) Type or print name of person signing Date signed Dated at (Town) Judgment (Refer to appropriate section below for orders) Motion is Denied Motion is Granted and the judgment entered in the above case is opened with respect to original order. Orders Probation/Conditional Discharge is: Continued. The original sentence of probation/conditional discharge and the conditions imposed remain in effect with no changes. Revoked. The defendant is sentenced to serve the sentence imposed or a lesser sentence as follows: with the following conditions of probation/conditional discharge or see attached information sheet. Terminated. The defendant is discharged/released from probation/supervision. (Discharge from probation is not permitted if convicted of a violation of sections 53-21(2) in effect prior to October 2, 2000, 53-21(a)(2), 53a-70, 53a-70a, 53a-70b, 53a-71, 53a-72a, or 53a-72b of the Connecticut General Statutes). Modified. The original sentence remains in effect, but conditions of probation/conditional discharge are modified or enlarged as follows: Extended, as follows: Discharge extended to/by (date certain/period of time) with the following conditions of probation/conditional discharge or or, Probation/Conditional to begin on (date) see attached information sheet. Name of Judge Name of Prosecutor Name of Reporter/Monitor Judgment entered at (Town) On (Date) Signed (Judge/Assistant Clerk) Original - Clerk to file under date of this order Copy - Probation/CSSD American LegalNet, Inc. www.FormsWorkFlow.com