Form Results Table
| Form No. | Name of Form | Version | Form | Print | Download |
| JD-AP-018 |
Out of State Travel Permit, Agreement to Return
|
Rev.
05/07
|
|
|
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| JD-AP-018M |
Non-Compact Misdemeanor Travel Permit/Agreement to Return
|
Rev.
06/08
|
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| JD-AP-018S |
Out of State Travel Permit, Agreement to Return - Spanish
|
Rev.
05/07
|
|
|
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| JD-AP-025 |
Presentence Investigation/Alternative Incarceration Assessment Report
|
Rev.
05/17
|
|
|
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| JD-AP-046 |
Notice To Appear and Complaint - Violation of Probation or Conditional Discharge
|
Rev.
05/19
|
|
|
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| JD-AP-046P |
Notice To Appear and Complaint - Violation of Probation or Conditional Discharge - Polish
|
Rev.
05/19
|
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| JD-AP-046PT |
Notice To Appear and Complaint - Violation of Probation or Conditional Discharge - Portuguese
|
Rev.
05/19
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| JD-AP-046S |
Notice To Appear and Complaint - Violation of Probation or Conditional Discharge - Spanish
|
Rev.
05/19
|
|
|
|
| JD-AP-049.01 |
Letter To Report, Stamford
|
Rev.
01/08
|
|
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| JD-AP-049.02 |
Letter To Report, Bridgeport
|
Rev.
08/14
|
|
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| JD-AP-049.03 |
Letter To Report, Danbury
|
Rev.
01/00
|
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| JD-AP-049.04 |
Letter To Report, Waterbury
|
Rev.
01/00
|
|
|
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| JD-AP-049.07 |
Letter To Report, Meriden
|
Rev.
03/08
|
|
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| JD-AP-049.08 |
Letter To Report, New Haven
|
Rev.
05/00
|
|
|
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| JD-AP-049.08A |
Letter To Report, New Haven Adult Supervision
|
Rev.
09/00
|
|
|
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| JD-AP-049.09 |
Letter To Report, Middletown
|
Rev.
09/00
|
|
|
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| JD-AP-049.09A |
Letter To Report, Middletown (Court Street)
|
Rev.
03/01
|
|
|
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| JD-AP-049.10 |
Letter To Report, New London
|
Rev.
02/00
|
|
|
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| JD-AP-049.10A |
Letter To Report, New London (Court)
|
Rev.
06/00
|
|
|
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| JD-AP-049.11A |
Letter To Report, Danielson (Intake)
|
Rev.
06/01
|
|
|
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| JD-AP-049.11D |
Letter To Report, Danielson (Adult Supervision)
|
Rev.
05/01
|
|
|
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| JD-AP-049.11W |
Letter To Report, Willimantic
|
Rev.
06/01
|
|
|
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| JD-AP-049.12 |
Letter To Report, Manchester
|
Rev.
07/02
|
|
|
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| JD-AP-049.13 |
Letter To Report, Enfield
|
Rev.
01/00
|
|
|
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| JD-AP-049.14 |
Letter To Report, Hartford
|
Rev.
01/00
|
|
|
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| JD-AP-049.15 |
Letter To Report, New Britain
|
Rev.
01/00
|
|
|
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| JD-AP-049.17 |
Letter To Report, Bristol
|
Rev.
05/00
|
|
|
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| JD-AP-049.18 |
Letter To Report, Bantam
|
Rev.
01/00
|
|
|
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| JD-AP-049.20 |
Letter To Report, Norwalk
|
Rev.
09/13
|
|
|
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| JD-AP-049.21 |
Letter To Report, Norwich
|
Rev.
10/99
|
|
|
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| JD-AP-049.22 |
Letter To Report, Milford
|
Rev.
01/99
|
|
|
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| JD-AP-062 |
Notice of Restitution/Donation Payment Procedure - Spanish on back
|
Rev.
04/21
|
|
|
|
| JD-AP-062P |
Notice of Restitution/Donation Payment Procedure - Polish
|
Rev.
04/21
|
|
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| JD-AP-062PT |
Notice of Restitution/Donation Payment Procedure - Portuguese
|
Rev.
04/21
|
|
|
|
| JD-AP-063 |
Interstate Compact - Probation, Order Of Incarceration And Release
|
Rev.
07/11
|
|
|
|
| JD-AP-110 |
Conditions of Probation
|
Rev.
07/11
|
|
|
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| JD-AP-110P |
Conditions of Probation (Polish)
|
Rev.
07/11
|
|
|
|
| JD-AP-110S |
Conditions of Probation (Spanish)
|
Rev.
07/11
|
|
|
|
| JD-AP-114 |
Transfer of Supervision
|
Rev.
01/08
|
|
|
|
| JD-AP-120 |
Employment History Request
|
Rev.
01/08
|
|
|
|
| JD-AP-137 |
Firearm Acknowledgment
|
Rev.
10/06
|
|
|
|
| JD-AP-137S |
Firearm Acknowledgment - Spanish
|
Rev.
10/06
|
|
|
|
| JD-AP-138 |
Voluntary Agreement To Search - Probationer Or Person Under Probation Supervision
|
Rev.
01/08
|
|
|
|
| JD-AP-139 |
Voluntary Agreement To Search, Controlling Third Party
|
Rev.
01/08
|
|
|
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| JD-AP-139P |
Voluntary Agreement to Search, Controlling Third Party - Polish
|
Rev.
01/08
|
|
|
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| JD-AP-139PT |
Voluntary Agreement to Search, Controlling Third Party - Portuguese
|
Rev.
01/08
|
|
|
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| JD-AP-139S |
Voluntary Agreement to Search, Controlling Third Party - Spanish
|
Rev.
01/08
|
|
|
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| JD-AP-140 |
Adult Probation, Record of Search
|
Rev.
03/07
|
|
|
|
| JD-AP-141 |
Consent to Record Meeting With CSSD Employee and to Release Information
|
Rev.
10/07
|
|
|
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| JD-AP-141P |
Consent to Record Meeting With CSSD Employee and to Release Information - Polish
|
Rev.
10/07
|
|
|
|
| JD-AP-141PT |
Consent to Record Meeting With CSSD Employee and to Release Information - Portuguese
|
Rev.
10/07
|
|
|
|
| JD-AP-141S |
Consent to Record Meeting With CSSD Employee and to Release Information - Spanish
|
Rev.
10/07
|
|
|
|
| JD-AP-142 |
Pre-Trial Intake/Condition Notification Letter
|
Rev.
03/08
|
|
|
|
| JD-AP-143 |
Warrant Service/Condition Notification Letter
|
Rev.
03/08
|
|
|
|
| JD-AP-144 |
Warrant Surrender/Supervision Letter
|
Rev.
04/10
|
|
|
|
| JD-AP-144P |
Warrant Surrender/Supervision Letter - Polish
|
Rev.
04/10
|
|
|
|
| JD-AP-144PT |
Warrant Surrender/Supervision Letter - Portuguese
|
Rev.
04/10
|
|
|
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| JD-AP-144S |
Warrant Surrender/Supervision Letter - Spanish
|
Rev.
04/10
|
|
|
|
| JD-AP-145 |
Alleged Misconduct By CSSD Employee Report Form
|
Rev.
07/08
|
|
|
|
| JD-AP-146 |
Notice of Stay Away Order
|
Rev.
08/08
|
|
|
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| JD-AP-147 |
Pre-Trial Supervision Progress Report
|
Rev.
08/08
|
|
|
|
| JD-AP-148 |
Notice of No Contact With Victim Order
|
Rev.
12/13
|
|
|
|
| JD-AP-149 |
Eligibility Referral/Treatment Plan Supervised Diversionary Program
|
Rev.
05/11
|
|
|
|
| JD-AP-149V |
Eligibility Referral/Treatment Plan Supervised Diversionary Program For Veterans
|
Rev.
07/14
|
|
|
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| JD-AP-150 |
Supervised Diversionary Program Conditions
|
Rev.
09/08
|
|
|
|
| JD-AP-151 |
Juvenile Probation Flexible Funding Request Form
|
Rev.
10/08
|
|
|
|
| JD-AP-152 |
Review of Probation Term
|
Rev.
05/09
|
|
|
|
| JD-AP-153 |
Expedited Inmate Medication Process
|
Rev.
09/09
|
|
|
|
| JD-AP-155 |
Acknowledgment of Confidentiality
|
Rev.
05/10
|
|
|
|
| JD-AP-156 |
Violation of Probation, Request For Arrest Under C.G.S. § 53a-32
|
Rev.
09/10
|
|
|
|
| JD-AP-157 |
Notice To Person Required To Give A DNA Sample To CSSD, (Spanish on Back)
|
Rev.
10/11
|
|
|
|
| JD-AP-158 |
Affidavit in Support of Violation of Probation Arrest Under Section 53a-32 of the Connecticut General Statutes
|
Rev.
09/10
|
|
|
|
| JD-AP-159 |
Probation Warrantless Arrest Detention Order - Interstate Compact
|
Rev.
10/10
|
|
|
|
| JD-AP-160 |
Probation Warrantless Arrest Detention Order - Interstate Compact Notice of Violation and Rights
|
Rev.
10/10
|
|
|
|
| JD-AP-161 |
Victim Notice
|
Rev.
05/15
|
|
|
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| JD-AP-161S |
Victim Notice - Spanish
|
Rev.
05/15
|
|
|
|
| JD-AP-162 |
Split Sentence Victim Notice
|
Rev.
01/11
|
|
|
|
| JD-AP-162S |
Split Sentence Victim Notice - Spanish
|
Rev.
01/11
|
|
|
|
| JD-AP-163 |
Probation Supervision Progress Report In Response To A New Arrest
|
Rev.
02/11
|
|
|
|
| JD-AP-164 |
Transfer of Seized Property
|
Rev.
05/11
|
|
|
|
| JD-AP-165 |
Sentence Modification Application, Motion and Order - Intensive Probation Supervision
|
Rev.
10/12
|
|
|
|
| JD-AP-165A |
Sentence Modification Community Release Plan Related to Application, Motion and Order, Intensive Probation Supervision
|
Rev.
10/12
|
|
|
|
| JD-AP-166 |
Bail Ordered Amount and Conditions
|
Rev.
10/19
|
|
|
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| JD-AP-167 |
Adult Probation - Notice of Application for Sentence Modification
|
Rev.
10/11
|
|
|
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| JD-AP-168 |
Early Release to Intensive Probation Supervision
|
Rev.
03/12
|
|
|
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| JD-AP-170 |
Notice to Contact or Report to Probation Officer
|
Rev.
07/12
|
|
|
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| JD-AP-171 |
Discharge Plan
|
Rev.
02/15
|
|
|
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| JD-AP-171S |
Discharge Plan - Spanish
|
Rev.
02/15
|
|
|
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| JD-AP-172 |
Interstate Compact Notice/Waiver of Probable Cause Hearing
|
Rev.
11/11
|
|
|
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| JD-AP-172S |
Interstate Compact Notice/Waiver of Probable Cause Hearing (Spanish)
|
Rev.
11/11
|
|
|
|
| JD-AP-173 |
Interstate Compact Notice of Violation of Conditions of Probation
|
Rev.
11/11
|
|
|
|
| JD-AP-175 |
Conditions of Supervision - Technical Violation Unit
|
Rev.
12/11
|
|
|
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| JD-AP-175P |
Conditions of Supervision - Technical Violation Unit - Polish
|
Rev.
12/11
|
|
|
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| JD-AP-175PT |
Conditions of Supervision - Technical Violation Unit - Portuguese
|
Rev.
12/11
|
|
|
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| JD-AP-175S |
Conditions of Supervision - Technical Violation Unit - Spanish
|
Rev.
12/11
|
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|
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| JD-AP-176 |
Interstate Compact - Probation, Probable Cause Hearing
|
Rev.
12/11
|
|
|
|
| JD-AP-177 |
Recommendation for Intensive Pretrial Supervision
|
Rev.
01/13
|
|
|
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| JD-AP-178 |
Intensive Pretrial Supervision Progress Report
|
Rev.
03/12
|
|
|
|
| JD-AP-179 |
Request by Adult Probation Services for Access to Family Violence Case Records
|
Rev.
01/12
|
|
|
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| JD-AP-180 |
Request For Extension of Time To Complete Presentence Investigation Report
|
Rev.
12/12
|
|
|
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| JD-AP-191 |
Victim Impact Panel Notice - Adult Probation
|
Rev.
12/15
|
|
|
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| JD-AP-191P |
Victim Impact Panel Notice - Adult Probation - Polish
|
Rev.
12/15
|
|
|
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| JD-AP-191PT |
Victim Impact Panel Notice - Adult Probation - Portuguese
|
Rev.
12/15
|
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|
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| JD-AP-191S |
Victim Impact Panel Notice - Adult Probation - Spanish
|
Rev.
12/15
|
|
|
|
| JD-AP-192 |
Pardon Eligibility Notice
|
Rev.
02/21
|
|
|
|
| JD-AP-193 |
Under 21 Motor Vehicle/Underage Drinking Program Notice
|
Rev.
10/16
|
|
|
|
| JD-AP-194 |
Affidavit Regarding Restitution Obligation
|
Rev.
10/17
|
|
|
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| JD-AP-195 |
Notice of Remaining Restitution Obligation
|
Rev.
10/17
|
|
|
|
| JD-AP-196 |
Case Data Record - Record Check
|
Rev.
11/18
|
|
|
|
| JD-AP-197 |
Interaction with Federal Immigration Authorities
|
Rev.
10/19
|
|
|
|
| JD-AP-198 |
Notice to Victim of Arrest for Violation of Probation
|
Rev.
12/20
|
|
|
|
| JD-AP-198P |
Notice to Victim of Arrest for Violation of Probation - Polish
|
Rev.
12/20
|
|
|
|
| JD-AP-198PT |
Notice to Victim of Arrest for Violation of Probation - Portuguese
|
Rev.
12/20
|
|
|
|
| JD-AP-199 |
Restitution/Donation Order Introduction Letter
|
Rev.
12/21
|
|
|
|
| JD-AP-202 |
Victim Restitution Notice and Request for Information
|
Rev.
12/21
|
|
|
|
| JD-AP-203 |
Victim Restitution Notice and Second Request for Information
|
Rev.
12/21
|
|
|
|
| JD-AP-204 |
Victim Restitution Claim
|
Rev.
12/21
|
|
|
|
| JD-AP-205 |
Victim Notice - No Restitution Owed
|
Rev.
12/21
|
|
|
|
| JD-AP-207 |
Adult Probation Officer use of Force/Arrest Report
|
Rev.
06/22
|
|
|
|
| JD-AP-208 |
Victim Impact Panel Notice - Pretrial Services
|
New
04/22
|
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|
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| JD-AP-208P |
Victim Impact Panel Notice - Pretrial Services - Polish
|
New
04/22
|
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|
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| JD-AP-208PT |
Victim Impact Panel Notice - Pretrial Services - Portuguese
|
New
04/22
|
|
|
|
| JD-AP-208S |
Victim Impact Panel Notice - Pretrial Services - Spanish
|
New
04/22
|
|
|
|
| JD-AP-209 |
Notice of Placement for Evaluation - Pretrial Impaired Driving Intervention or Drug Intervention and Community Service Program (Spanish on Back)
|
New
04/22
|
|
|
|
| JD-AP-209P |
Notice of Placement for Evaluation - Pretrial Impaired Driving Intervention or Drug Intervention and Community Service Program - Polish
|
New
04/22
|
|
|
|
| JD-AP-209PT |
Notice of Placement for Evaluation - Pretrial Impaired Driving Intervention or Drug Intervention and Community Service Program - Portuguese
|
New
04/22
|
|
|
|
| JD-AP-210 |
Notice of Placement - Pretrial Impaired Driving Intervention Program
|
New
04/22
|
|
|
|
| JD-AP-210P |
Notice of Placement - Pretrial Impaired Driving Intervention Program - Polish
|
New
04/22
|
|
|
|
| JD-AP-210PT |
Notice of Placement - Pretrial Impaired Driving Intervention Program - Portuguese
|
New
04/22
|
|
|
|
| JD-AP-211 |
Notice of Placement - Pretrial Drug Intervention and Community Service Program (Spanish on Back)
|
New
04/22
|
|
|
|
| JD-AP-211P |
Notice of Placement - Pretrial Drug Intervention and Community Service Program - Polish
|
New
04/22
|
|
|
|
| JD-AP-211PT |
Notice of Placement - Pretrial Drug Intervention and Community Service Program - Portuguese
|
New
04/22
|
|
|
|
| JD-AP-212 |
Pretrial Drug Intervention and Community Service Program, Community Service Record
|
New
04/22
|
|
|
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| JD-AP-213 |
Pretrial Drug Intervention and Community Service Program, Community Service Completion Report
|
New
04/22
|
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