Department Of Corrections Approval To File Petition For Determination Of Eligibility For The Substance Abuse Program
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Department Of Corrections Approval To File Petition For Determination Of Eligibility For The Substance Abuse Program Form. This is a Wisconsin form and can be use in Circuit Court Statewide.
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Tags: Department Of Corrections Approval To File Petition For Determination Of Eligibility For The Substance Abuse Program, CR-264, Wisconsin Statewide, Circuit Court
For Official Use
STATE OF WISCONSIN, CIRCUIT COURT,
COUNTY
Amended
State of Wisconsin
-vs, Defendant
Name
Department of Corrections
Approval to File Petition for
Determination of Eligibility
for the Substance Abuse
Program
§302.05(3)(e)
Case No.
Date of Birth
1. The petitioner is presently serving the confinement portion of a bifurcated sentence. The petitioner was not
convicted of a crime specified in chapter 940 or §§948.02, 948.025, 948.03, 948.05, 948.055, 948.06,
948.07, 948.075, 948.08 or 948.095, Wis. Stats.
2. The court has not yet determined if the petitioner is eligible or ineligible to participate in the Substance Abuse
Program.
3. The Department of Corrections approves filing of the Petition for Determination of Eligibility for the Substance
Abuse Program.
State of
County of
Subscribed and sworn to before me on
Department of Corrections Representative
Name Typed or Printed
Notary Public/Court Official
Date
Name Printed or Typed
My commission/term expires:
DISTRIBUTION:
1. Court – Original
2. Department of Corrections
CR-264, 08/11 Department of Corrections Approval to File Petition for Determination of Eligibility for the Substance Abuse Program
DOC-2251
This form shall not be modified. It may be supplemented with additional material.
§302.05(3)(e), Wis. Stats.
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