Form SC-6.4(B) "Inventory of Special Conditions of Probation" - Georgia (United States)

Form SC-6.4(B) or the "Inventory Of Special Conditions Of Probation" is a form issued by the Georgia Superior Courts.

A PDF of the latest Form SC-6.4(B) can be downloaded below or found on the Georgia Superior Courts Forms and Publications website.

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Download Form SC-6.4(B) "Inventory of Special Conditions of Probation" - Georgia (United States)

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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
serve ____________ days in
County Diversion Center
_.
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
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
serve ____________ days in
County Diversion Center
_.
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
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
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.___ Electronic monitoring device. The Defendant shall submit to:
e for a period
of: _____
have the device installed prior to release from custody.
24.___ Administrative or terminated probation. The Defendant’s probation sentence
shall:
terminate upon full and timely payment of all
sums due hereunder and compliance with all Conditions of Probation, including
Special Conditions of Probation.
25.___ DNA sample. The Defendant has been convicted of a felony offense. In
accordance with O.C.G.A. § 35-3-160, the Defendant shall provide a DNA
sample.
State of Georgia v. ____________________
Criminal Action # _____________________
SC-6.4(B) Inventory of Special Conditions of Probation
Page 3 of 5
26.___ Sex offender special conditions.
The Defendant is subject to Special
Conditions of Probation as a sex offender. These conditions are described
more fully on separate pages which are incorporated into this sentence by
reference.
27.___ Offense against a minor or dangerous sexual offense special conditions.
The Defendant is subject to Special Conditions of Probation under O.C.G.A. §
42-8-35(b), as a person who has been convicted of a criminal offense against a
minor or a dangerous sexual offense as defined in O.C.G.A. § 42-1-12. These
conditions are described more fully on a separate page which is incorporated
into this sentence by reference.
28.___ Stalking or aggravated stalking special conditions.
The Defendant is
subject to Special Conditions of Probation for violation of O.C.G.A. §§ 16-5-90
or 16-5-91. These conditions are described more fully on a separate page
which is incorporated into this sentence by reference.
29.___ Street gang activity. The Defendant has been convicted of a violation of the
Georgia Street Gang Terrorism and Prevention Act and shall not knowingly have
contact of any kind or character with any other member or associate of a
criminal street gang, shall not participate in any criminal gang activity, and, if this
case involved a victim, shall not knowingly have contact of any kind or character
with any such victim or any member of any such victim's family or household.
30.___ Special probation for drug offense. The Defendant has been convicted of a
drug offense in violation of O.C.G.A. § 16-13-30(b), § 16-13-30(d) or § 16-13-31
and is subject to a special term of probation of three years in addition to the term
of imprisonment imposed by the Court. If this is a second violation, the special
term of probation shall be six years in addition to the term of imprisonment.
31.___ Testify truthfully. The Defendant shall not refuse to testify, but shall testify fully
and truthfully as to all circumstances of this case and any related matters.
32.___ Avoid alcohol, drug use.
beverages, and not use narcotics or dangerous drugs unless lawfully prescribed
consume alcohol and operate a motor veh
serve alcohol.
33.___ Contagious disease. The Defendant shall submit to evaluation and provide
proof of treatment as required by any governmental unit for any contagious
communicable disease constituting a public health risk.
State of Georgia v. ____________________
Criminal Action # _____________________
SC-6.4(B) Inventory of Special Conditions of Probation
Page 4 of 5
Other special condition(s). The Defendant shall abide by the following
additional special condition(s): _______________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
SO ORDERED this ________day of _____________________, 20______.
___________________________________________
Judge of Superior Court
_______________________________ Judicial Circuit
___________________________________________
(print or stamp Judge’s name)
Acknowledgment: I have read the terms of this document or had them read and
explained to me. I understand that violation of a special condition of probation could
result in revocation of all time remaining on the period of probation.
___________________________________
Defendant
State of Georgia v. ____________________
Criminal Action # _____________________
SC-6.4(B) Inventory of Special Conditions of Probation
Page 5 of 5
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