COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... Michael. J.. Dillon. . . : Court Administrator MONTHLY SUPERVISION REPORT Index No. 12TH DISTRICT COURT PROBATION : 312 South Jackson Street Jackson, Michigan 49201 : Plaintiff(s) (517) 788-4280 www.d12.com : Tamara J. Bates Chief Probation Officer -against- Calendar No. JUDICIAL : Probation Officers: Edward Alexander Ken Ashenfelter Tammy Barrett Lisa Grzesek Da’Neese Merritt SUBPOENAPhilip Rutledge Karen Taylor Jim Hunt, ISP, Scott Vitale, ISP : TODAYS DATE: ___________________________ PROBATION OFFICER: ____________________________ Defendant(s) : ................................................. NAME: ______________________________________________. . . . . HOME PHONE: ______________________ ADDRESS:___________________________________________ THE PEOPLE OF THE STATE OF NEW YORK OTHER PHONE: _____________________ TO Persons living with you: ________________ CITY, STATE & ZIP: __________________________________ ____________________________________________________ Mailing address (if different than above) ____________________________________ Name and Address of Employer: Employer Phone Number: GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Name of Supervisor: , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed Normal Work Day and Hours: to testify and give evidence as a witness in this action onIncome: of the Monthly the part or adjourned date, If Unemployed, how long have you been unemployed: Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. List vehicles owned and/or driven by you: List year, make, model color and license plate: Witness, Honorable Court in County, , one of the Justices of the day of , 20 Have you had any contact with a law enforcement officer/agency since your last report? yes no (Attorney must sign above and type name below) If yes, list the date _____________ and agency __________________________ Reason: Attorney(s) for Office and P.O. Address Have you been ordered to attend one of the following: alcohol counseling, substance abuse counseling, mental health counseling and/or the Aggressive Intervention Program (AIM)? yes ) no If yes, have you been attending? yes no Telephone No.: If no, what is your reason for not attending: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : Have you been ordered to complete community service? no JUDICIAL SUBPOENA Plaintiff(s) yes If yes, have you been attending and how many days are remaining : ________________ -against: If no, what is your reason for not attending? : : Have you been ordered to attend high school and/or obtain a G.E.D. Certificate? : If yes, have .you. been.attending. . . . . . . yes. . . . . .no .Defendant(s) . . . . . . . ... .. .... ....... .. .. .......... If no, what is your reason for not attending? yes no THE PEOPLE OF THE STATE OF NEW YORK Did you TO a payment today? make yes no If yes, how much:_________________ If no, when will you make your next payment? GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before yes Court no , located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed Additional adjourned date, mytestify and give evidence as a witness in this action on the part of the or comments for to probation officer: I need tothe Honorableappointment with my probation officer: schedule an at the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) I CERTIFY THAT ALL OF THE INFORMATION GIVEN BY ME IN THIS REPORT IS TRUE AND TO THE BEST OF MY KNOWLEDGE AND BELIEF: Attorney(s) for Signed: ______________________________________ FOR OFFICIAL USE ONLY: Probation Officer notes: Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: D12PB –1 (5/01) American LegalNet, Inc. www.USCourtForms.com