0 - NY DCJS



|CONDITIONAL DISCHARGE / PROBATION |DATE |

|IGNITION INTERLOCK |      |

|NOTIFICATION TO COURT AND DISTRICT ATTORNEY | |

| |CASE # |

| |      |

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|SENTENCING COURT AND DISTRICT ATTORNEY ARE TO BE NOTIFIED WITHIN 5 BUSINESS DAYS OF ALLEGED VIOLATION(S) BECOMING KNOWN |

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|JUDGE |DEFENDANT (LAST) |(FIRST) |(M.I.) |

|      |      |      |      |

|COURT |FROM |

|      |      |

|COUNTY | |

|      | |

| DEFENDANT HAS BEEN ORDERED TO INSTALL AN IGNITION INTERLOCK DEVICE (IID) IN ADVANCE OF SENTENCE AND SUBSEQUENT TO AN ARREST FOR: |

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|DEFENDANT WAS: |

|CONVICTED OF |      |AS A (FELONY) (MISDEMEANOR) |AND |

|SENTENCED TO (A CONDITIONAL DISCHARGE) (PROBATION) ON |      |FOR |      |YEARS |

|BY THE HONORABLE |      |, |      |COURT |

|SPECIAL CONDITIONS RELATED TO IGNITION INTERLOCK |

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|THE MONITORING AGENT ALLEGES THAT THERE IS REASONABLE CAUSE TO BELIEVE THAT THE ABOVE DEFENDANT VIOLATED A CONDITION OF SENTENCE AS FOLLOWS: |

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|FAILED TO HAVE IGNITION INTERLOCK DEVICE INSTALLED ON REQUIRED VEHICLE(S) [SEE DETAILS OF ALLEGED VIOLATIONS SECTION BELOW] |

|FAILED TO COMPLY WITH A SERVICE VISIT REQUIREMENT AND HAS NOT HAD HIS/HER VEHICLE PROMPTLY |

|SERVICED WITHIN THE THREE BUSINESS DAYS IMMEDIATELY FOLLOWING THE MISSED SERVICE APPOINTMENT |

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|A DEVICE REPORT INDICATES POSSIBLE TAMPERING WITH OR CIRCUMVENTION OF THE IGNITION INTERLOCK DEVICE OR AN ATTEMPT THEREOF. |

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|A REPORT OF A FAILED START-UP RE-TEST |

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|A REPORT OF A MISSED START-UP RE-TEST |

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|A REPORT OF A FAILED ROLLING RE-TEST |

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|A REPORT OF A MISSED ROLLING RE-TEST |

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|VIOLATED OTHER CONDITIONS OF THE SENTENCE. |

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|THIS NOTIFICATION IS BEING MADE PURSUANT TO TITLE 9 NYCRR PART 358 WHICH REQUIRES THAT |

|THE COURT AND DISTRICT ATTORNEY’S OFFICE ARE NOTIFIED OF CERTAIN EVENTS. |

|DETAILS OF ALLEGED VIOLATIONS |

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|CONTINUED ON ATTACHED PAGE |

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| NON-INSTALLATION OF AN IID: THE ABOVE-NAMED DEFENDANT HAS BEEN FOUND, THROUGH A NYS DMV REGISTRATION/ TITLE CHECK CONDUCTED ON       (MM/DD/YYYY), TO BE |

|THE OWNER OF A MOTOR VEHICLE (VIN#:     ) WITHOUT AN IGNITION INTERLOCK DEVICE INSTALLED AS REQUIRED. THE RECOMMENDATIONS OF THIS AGENCY CAN BE FOUND ON |

|PAGE 2 OF THIS FORM. |

| GOOD CAUSE FOR NON-INSTALLATION REQUIRED: THE ABOVE-NAMED DEFENDANT HAS BEEN FOUND, THROUGH A NYS DMV REGISTRATION/ TITLE CHECK CONDUCTED ON       |

|(MM/DD/YYYY), TO BE THE OWNER OF A MOTOR VEHICLE (VIN#:     ) WITHOUT AN IGNITION INTERLOCK DEVICE INSTALLED AS REQUIRED. WHILE THE OPERATOR CLAIMS TO NO |

|LONGER OWN THIS VEHICLE, IT REMAINS ON HIS/HER DMV RECORD. PLEASE CALENDAR THIS CASE IN ORDER TO ADDRESS THE MATTER AND/OR ALLOW THE DEFENDANT TO PROVIDE |

|DOCUMENTATION WHICH SUPPORTS A FINDING OF “GOOD CAUSE” FOR NON-INSTALLATION. |

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|ACTION(S) TAKEN BY MONITORING AUTHORITY |

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|CONTINUED ON ATTACHED PAGE |

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|MONITORING AUTHORITY RECOMMENDATION TO COURT |DIRECTION BY COURT |

|1. AWAIT ADJUDICATION ON NEW CHARGES BEFORE TAKING FURTHER ACTION | SO ORDERED |

|2. SEND DEFENDANT “NOTICE TO APPEAR” IN COURT FOR: | SO ORDERED |

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|ARRAIGNMENT AS VIOLATOR | |

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|HEARING REGARDING SENTENCE STATUS | |

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|RECOMMENDED COURT DATE: | |

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| | OTHER DATE DIRECTED BY |

| |COURT: |

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|3. ISSUE WARRANT FOR DEFENDANT | SO ORDERED |

|4. NO ACTION REQUESTED. NOTIFICATION IS BEING MADE FOR INFORMATIONAL PURPOSES ONLY. | SO ORDERED |

|6. OTHER RECOMMENDATION: | DATED |

| |      |

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|SIGNATURE OF MONITOR/PROBATION OFFICER |DATED |

| |      |

|PRINT NAME OF MONITOR/PROBATION OFFICER | |

|      | |

|SIGNATURE OFJUDGE |DATED |

| |      |

|PRINT NAME OF JUDGE | |

|      | |

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