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Revocation Order Form. This is a Tennessee form and can be use in Williamson Local County.
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Tags: Revocation Order, Tennessee Local County, Williamson
IN THE CIRCUIT COURT OF WILLIAMSON COUNTY, TENNESSEE
REVOCATION ORDER
Case Number ____________________________ Count #: ______ Attorney for State _______________________________
Judicial District: ________ Judicial Division: ________
Counsel for Defendant ____________________________________
Retained
Appointed
Public Defender
State of Tennessee
vs
Defendant ____________________________________________________ Alias ________________________________
Date of Birth _________________________ Sex ______ Race ________ SSN: _________________________________
On the ___________ day of _______________________, 200___,
{
{
{
{
X__________________________________________
Defendants signature – required for waiver
} “By Agreement” of Counsel
} Waived hearing & admitted violation & to serve original sentence.
} Admitted the Violation & agreement of State; { } to be heard by Court
} After hearing, the defendant is found to be;
{ } in violation
{ } not in violation, warrant dismissed
** Convicted Offense _________________________________________________
________________________________________________________________
(
) FELONY
(
) MISDEMEANOR
** ORIGINAL SENTENCE LENGTH: ___________________________________________
_________________________________________________________________
{
} Probation Revoked
{ } Full Revocation; Serve Original Sentence Imposed
{ } Partial revocation: Serve _______ years ________ months _______ days – { } (day for day) / {
{ } Workhouse
{ } T.D.O.C.
{ } County Jail
{
} Remainder of Sentence:
{
} Community Corrections Revoked
{ } Full Revocation; Serve Original Sentence Imposed or as Modified
{
{
} Probation
{ } Community Corrections
{ } Termination
{ } Transfer to Community Corrections Program
{ } Reinstate to Probation
{
} Partial Revocation: serve _____ years _______ months ______ days
{
{ } Remainder of Sentence: { } Probation
} Reinstate to Community Corrections Program
Credit for time served:
{
} at ________%)
} County Jail
{
{
} Re-Sentence to _____ yr ______ mo. _____days
{
} County Jail {
} Community Corrections {
{ } Transfer to Probation
} Workhouse {
} T.D.O.C.
} Terminated
} Community Corrections Program
From _____/_____/_____ to _____/_____/_____.
From _____/_____/_____ to _____/_____/_____.
Total days credited _________________________________
SPECIAL CONDITIONS: ______________________________________________________________
______________________________________________________________________________
______________________
JUDGE’S NAME
DATE OF ENTRY
___________________________________________________
JUDGE’S SIGNATURE
__________________________________
ATTY. FOR STATE
{OPTIONAL}
________________________________________
ATTY. FOR DEFENDANT
{OPTIONAL}
revised 2-03
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