SC-6.4(B) Inventory of Special Conditions of Probation INVENTORY OF SPECIAL CONDITIONS OF PROBATION These conditions are hereby incorporated into the Defendant's sentence by reference. The Defendant is advised that violation of any Special Condition of Probation may subject the Defendant to a revocation of the balance of the period of probation and the Defendant may be required to serve up to the balance of the sentence in confinement. (Judge to designate conditions to be applied.) 1. ___ The Court finds that the Defendant shall pay restitution in the amount of $_______________ through the Probation Office for the benefit of the victim(s) __________________________________________, at a rate to be approved by the Court or the Probation Officer. 2.___ The Defendant shall report to the Probation Office at ___________________ _______________, Georgia by no later than ________________________. 3.___ The Defendant shall perform ____________ hours of community service at the direction of the Probation Officer, to be completed within ________ days of this date, with transportation to be provided by the Defendant. 4.___ The Defendant is sentenced under the provisions of the Probation Management Act Sentencing Options System with a: sanction cap of Probation Detention Center or Regional Substance Abuse Treatment Facility; or Court-designated sanction cap of ___________________________________________________. 5.___ Accountability Court referral. The Defendant shall enter and complete the ________________________________ Accountability Court and comply with all terms and conditions of that program. 6.___ Reserved. 7.___ Detention Center, Diversion Center, or Boot Camp. The Defendant shall County Diversion Center serve ____________ days in _. The Defendant shall be subject to the rules and regulations of the facility. The Defendant is sentenced to ________________ in confinement, with that time suspended upon acceptance into the facility. into the facility shall be credited toward the time to be served at the facility. he Defendant may be at liberty until the date of acceptance into the facility. 8.___ Regional Substance Abuse Treatment (RSAT) Facility. The Defendant shall enter and complete a Regional Substance Abuse Treatment Program. The Defendant is sentenced to ________________ in confinement, with that time suspended upon acceptance into the facility. State of Georgia v. ___________________ Criminal Action # ____________________ Page 1 of 5 American LegalNet, Inc. www.FormsWorkFlow.com 9.___ Day Reporting Center. The Defendant shall be assigned to a Day Reporting Center and shall be subject to all the rules and regulations of the facility. The Defendant is sentenced to ________________ in confinement, with that time suspended upon acceptance into the facility. 10.___ Fourth Amendment waiver. The Defendant shall submit to a search of person, residence, papers, vehicle, and/or effects at any time of day or night without a search warrant, whenever requested to do so by a Probation Officer or other law enforcement officer upon reasonable cause to believe that the Defendant is in violation of probation or otherwise acting in violation of the law, and the Defendant shall specifically consent to the use of anything seized as evidence in any judicial proceedings or trial. 11.___ Specimen; admissibility. The Defendant shall produce from time to time upon oral or written request by a Probation Officer, a law enforcement officer, or official of a Georgia DHS-approved substance abuse or mental health provider personnel a breath, saliva, urine and/or blood specimen for analysis for the presence of drugs including alco foundation for admissibility of the laboratory results. 12.___ Limited or no contact. The Defendant shall: ____ yards away from nt contact with person, or by telephone, mail, or otherwise, with _____________________ he Defendant shall not enter the premises of ___________________________. 13.___ Harassment, threats. The Defendant shall not harass, threaten, intimidate, physically or verbally abuse, or harm the following person(s): ______________________________. 14.___ Family Violence Intervention Program (FVIP). The Defendant has been convicted of a crime involving family violence and is required to participate in a Family Violence Intervention Program certified by the State. 15.___ Records release. The Defendant shall provide a release which allows the Probation Office to have access to all medical, clinical, treatment, attendance or work records, and for driving and criminal history. 16.___ Evaluation and treatment. The Defendant shall provide verification of evaluation and/or treatment for: evaluation training or ___________ at a State- or Court-approved provider at his/her own expense, and shall cooperate and comply with all rules and regulations of the treatment or program, including any aftercare deemed necessary. State of Georgia v. ____________________ Criminal Action # _____________________ SC-6.4(B) Inventory of Special Conditions of Probation Page 2 of 5 American LegalNet, Inc. www.FormsWorkFlow.com 17.___ 12-step meetings. The Defendant shall provide verification of attendance at _________ 12-step meetings or an equivalent per week for ____________ 18.___ Diploma, GED, or training certificate. The Defendant shall provide verification of completion of a high school diploma, GED, or vocational training certificate. In the event he/she does not have one, the Defendant shall attend all classes and work successfully toward obtaining a diploma, GED, or certificate during the attendance. 19.___ Curfew. The Defendant shall abide by any curfew established by the Probation Officer. 20.___ Bar order. The Defendant shall not enter t the ________________ Judicial Circuit during the period of probation for any reason whatsoever. 21.___ Surrender driver's license. The Defendant shall surrender any motor vehicle operator's license or permit to the Clerk pursuant to O.C.G.A. § 40-5-75. 22.___ Ignition interlock. The Defendant shall have installed and maintain an ignition interlock device for six months in each motor vehicle registered or used by the Defendant. This period will begin when the Defendant has shown to the Court or to Probation Office certification that the Defendant's risk reduction program has been completed and that the ignition interlock system(s) has been installed. This provision shall not allow a defendant to drive whose license is under suspension. 23.___ Electron