MIKE POWELL, JUDGE Warren County Common Pleas Court Probate-Juvenile Division 570 Justice Drive Lebanon, Ohio 45036 Name ________________________________________ Case No(s). RULES OF ADULT COMMUNITY CONTROL In consideration of having been placed on community control until Select Month terms and conditions during the term of such community control: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Day Year , I agree to comply with the following I will obey federal, state and local laws and ordinances and all rules and regulations imposed by the Warren County Juvenile Court. I will report any arrest, citation for a violation of the law, or any contact with a law enforcement officer to my Community Control Officer no later than the next business day. I will always keep my Community Control Officer informed of my current residence, telephone number and place of employment. I will obtain permission from my Community Control Officer before changing my residence or my employment. I will report any such change to my Community Control Officer within two (2) business days of such change. I will not be present at any place where I know or have reason to know that a violation of law is occurring. I will avoid association with any person(s) who are incarcerated, on community control, house arrest, aftercare, parole, under court supervision or who are designated by my Community Control Officer or order of the Court. I will not leave the State of Ohio without the permission of my Community Control Officer. I will comply with all orders given to me by my Community Control Officer or other authorized representative of the Court, including any written instructions issued at any time during the period of supervision. I agree to sign a release of confidential information from any public or private agency if requested to do so by a Community Control Officer. I will not purchase, possess, own, use or have under my control any firearms, deadly weapons, ammunition or dangerous ordnance. I will not purchase, possess, own, use or have under my control any alcoholic beverage. I will not purchase, possess, own, use or have under my control any narcotic drug or other controlled substance including any instrument, device or other object used to administer such drugs or to prepare them for administration, except as lawfully prescribed for me by a licensed physician. I agree to inform my Community Control Officer promptly of any such prescription. I agree to submit to drug testing at my own expense, as directed by my Community Control Officer. I understand that failure to submit to drug testing or providing adulterated or spurious samples for testing will be considered as a positive drug test I will not enter into or remain at any place where alcoholic beverages are being served or offered for consumption on the premises. I will not have any association with persons under eighteen (18) year of age except: __________________________________________________________________________________________. SPECIAL CONDITIONS 14. I will enroll in and successfully complete: A. Specialized training in _____________________________________________________; B. GED Classes and obtain GED not later than ____________________________________; C. Warren County Workforce One employment training of ______ hours per day; D. Drug and alcohol: _____ assessment; ____ education; ____ intervention; _____ treatment and comply with all recommendations of such assessment, education, intervention and/or treatment; E. _____ Mental health assessment _____ Individual counseling; _____ Family counseling and comply with all recommendations of such assessment and/or counseling; F. Other: ____________________________________________________________________________________________ ____________________________________________________________________________________________ WCJC Form 15 American LegalNet, Inc. www.FormsWorkFlow.com _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ THE ADDRESS AND TELEPHONE NUMBER OF THE AGENCY(IES) TO WHICH YOU HAVE BEEN REFERRED FOR THE SERVICES SPECIFIED IN THIS ITEM 13 ARE SET FORTH UPON THE ADDENDUM(S) ATTACHED HERETO. THE ADDENDUM(S) ALSO SET FORTH THE DATE BY WHICH YOU ARE TO HAVE COMPLETED THE SERVICES. IT IS YOUR RESPONSIBILITY TO ARRANGE FOR THE SERVICES BY CONTACTING THE SPECIFIED AGENCY(IES). 15. I will obtain, not later than Select Month Year Full time employment; ____ Part time employment. 16. I will contact my Community Control Officer: ____by telephone; ____in person; ____Other (as follows) ___________________________________________________________________________________________________ ________________________________________________________. 17. I will avoid any association with __________________________________________________. 18. I will observe my parental responsibilities of support, maintenance, care, medical attention and education for my minor children. 19. I will ensure that my minor children attend school regularly and without unexcused absence or tardy and report to my Community Control Officer any failure of my minor children to do so. 20. I will control any conduct or relationship of my minor children which is detrimental or harmful to such minor child(ren) or which tends to defeat the execution of any order of disposition made by the Warren County Juvenile Court for such minor child(ren). 21. I will observe a curfew as follows: ________________________________________________. 22. I will observe house arrest as follows: ______________________________________________. 23. I will serve _____ hours of community service and obtain a letter of verification of hours served from the agency/entity served. Community service shall be for an agency/entity designated by my Community Control Officer. Community service shall be completed by ________________. 24. I will pay fines of $_____.___ and court costs of _____.___ on or before ________________________. 25. I will pay restitution of $ _______.___ in ____ weekly; ____ monthly installments of $ ______.___ commencing on ______________________________________________. 26. Other: ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ During the term of your community control, authorized community control officers who are engaged within the scope of their supervisory duties or responsibilities may search, with or without a warrant, your person, your place of residence, your motor vehicle, any other tangible or intangible personal property, or other real property in which the you have a right, title, or interest or for which you have the express or implied permission of a person with a right, title, or interest to use, occupy, or possess if the community control officer have reasonable grounds to believe that you are not abiding by the law or otherwise not complying with the conditions of your community control. I have read, and reviewed the foregoing with my Community Control Officer. I have been afforded an opportunity to discuss these community control terms and conditions with my Community Control Officer and to ask questions about these terms and conditions. I have received a copy of these terms and conditions of adult community control for my own reference. I understand and agree to each of the within terms and conditions of community control. I understand that failure to comply with any of same may result in being charged with a violation of community control and may result in imposition of any sentence, which was previously suspended, or a re-sentencing. In addition, I understand that I will be subject to the foregoing terms and conditions until I have been officially released from community control. Dated: _________________________ . Select Month Day Year __________________________________ Probationer __________________________________________ Community Control Officer (513)695-___________ Distribution: WCJC Form 15 American LegalNet, Inc. www.FormsWorkFlow.com ADDENDUM SERVICE: ______________________________________________________________________ AGENCY: ______________________________________________________________________ ADDRESS: ______________________________________________________________________ TELEPHONE: ______________________________________________________________________ COMPLETION DATE: Select Month Day Year SERVICE: ______________________________________________________________________ AGENCY: ______________________________________________________________________ ADDRESS: ______________________________________________________________________ TELEPHONE: ______________________________________________________________________ COMPLETION DATE: Select Month Day Year SERVICE: ______________________________________________________________________ AGENCY: ______________________________________________________________________ ADDRESS: ______________________________________________________________________ TELEPHONE: ______________________________________________________________________ COMPLETION DATE: Select Month Day Year WCJC Form 15 American LegalNet, Inc. www.FormsWorkFlow.com