Probation Monthly Report Form Details

The United States federal probation report provides an in-depth examination of the current state of federal probation, including statistics and information on program efficacy. The report is designed to provide a comprehensive overview of federal probation for Congress and other policy makers. It also serves as a resource for researchers, practitioners, and the public. This year's report covers topics such as case management practices, pretrial services, drug testing, sex offender management, and community corrections. It includes data from fiscal year 2016 and offers recommendations for improving the effectiveness of the federal probation system.

If you wish to look at some specific details about the PDF you intend to use, here's the information you should go through before completing the federal probation report.

QuestionAnswer
Form NameFederal Probation Report
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesfederalmonthlyreport, monthly probation reporting form, online probation monthly report form, usprobation reporting

Form Preview Example

PROB 8

 

 

(Rev. 09/00)

 

 

U.S. PROBATION OFFICE

 

 

MONTHLY SUPERVISION REPORT FOR THE MONTH OF

, 20

.

Name

Court Name (if different):

PART A: RESIDENCE (If new address, attach copy of lease/purchase agreement)

Street Address, Apt. Number:

Own or Rent?

Home Phone:

Cellular Phone:

Pager:

 

 

 

 

 

 

City, State, Zip Code:

 

Persons Living With You:

 

 

 

 

 

 

 

 

Secondary Residence

Own or Rent?

Did you move during the month?

9 Yes 9 No

 

 

 

If yes, date moved:

 

Reason for Moving:

Mailing Address (if different):

E-Mail Address

 

 

 

 

 

 

 

 

 

 

 

PART B: EMPLOYMENT (If unemployed, list source of support under Part D.)

 

Name, Address, Phone No. of Employer:

 

Name of Immediate Supervisor:

 

Is your employer aware of your

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

criminal status:

9 Yes

9 No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

How many days of work did you miss?

 

 

 

Why?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_________________________________________________________________

 

 

 

 

 

Position Held:

Gross Wages:

 

 

 

 

Normal Work Hours:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Did you change jobs?

9 Yes

9 No

 

If changed jobs or terminated,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Were you terminated?

9 Yes

9 No

 

state when and why:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART C: VEHICLES (List all vehicles owned or driven by you)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

Year/Make/Model/Color:

 

 

 

 

Mileage:

 

Tag Number:

 

 

 

Owner:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle I.D.#:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

Year/Make/Model/Color:

 

 

 

 

Mileage:

 

Tag Number:

 

 

 

Owner:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle I.D.#:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART D: MONTHLY FINANCIAL STATEMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net Earnings from Employment:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you rent or have access to:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a post office box?

9 Yes 9 No

a safe deposit box?

9 Yes 9 No

 

(Attach Proof of Earnings)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a storage space? 9 Yes

9 No

 

Other Cash Inflows:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name and Address of Location:

 

 

 

 

 

Box No. or Space

 

TOTAL MONTHLY CASH INFLOWS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL MONTHLY CASH OUTFLOWS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you have checking account(s)?

 

 

9 Yes 9 No

 

Does your spouse, significant other, or dependant have a checking or savings

 

Bank Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

account that you enjoy the benefits of or make occasional contributions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

toward?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Account No:

 

 

 

 

 

 

 

 

 

Balance:

 

 

 

9 Yes 9 No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you have savings account(s)?

9 Yes 9 No

 

Bank Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bank Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Account No:

 

 

 

 

 

 

 

 

 

Balance:

 

Account No:

 

 

 

 

 

 

 

 

 

Balance:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Attach a complete listing of all other financial account information, if you have

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

multiple accounts.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

List all expenditures over $500 (including e.g., goods, services, or gambling losses)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

 

 

 

 

 

 

Amount

 

Method of Payment

 

 

 

 

 

 

 

Description of Item

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROB 8

 

(09/00)

Page 2

 

 

 

PART E: COMPLIANCE WITH CONDITIONS OF SUPERVISION DURING THE PAST MONTH

Were you questioned by any law enforcement officers?

9 Yes

9 No

If yes, date:

Agency:

Reason:

Were you arrested or named as a defendant in any criminal case? 9 Yes 9 No

If yes, when and where?

Charges:

Disposition:

(Attach copy of citation, receipt, charges, disposition, etc.)

Were any pending charges disposed of during the month?

 

 

 

 

Was anyone in your household arrested or questioned by law enforcement?

 

 

 

 

 

9 Yes

9

No

 

 

 

 

 

 

 

 

 

 

9 Yes

9 No

 

 

 

 

If yes, date:

 

 

 

 

 

 

 

 

If yes, whom?

 

 

 

 

 

 

Court:

 

 

 

 

 

 

 

 

Reason:

 

 

 

 

 

 

Disposition:

 

 

 

 

 

 

 

Disposition:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you have any contact with anyone having a criminal record?

 

 

 

 

Do you possess or have access to a firearm?

 

 

 

 

 

 

 

 

 

9 Yes

9

No

 

 

 

 

 

 

 

 

 

 

9 Yes

9 No

 

 

 

 

If yes, whom?

 

 

 

 

 

 

 

If yes, why?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Did you possess or use any illegal drugs?

 

 

 

 

 

 

 

Did you travel outside the district without permission?

 

 

 

 

 

 

 

 

 

9 Yes

9

No

 

 

 

 

 

 

 

 

 

 

9 Yes

9 No

 

 

 

 

If yes, type of drug:

 

 

 

 

 

 

 

If yes, when and where?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you have a special assessment, restitution, or fine?

9 Yes

9 No

 

If yes, amount paid during the month:

 

 

 

 

Special Assessment:

 

 

 

 

 

Restitution:

 

 

Fine:

 

____

 

 

NOTE: ALL PAYMENTS TO BE MADE BY MONEY ORDER (POSTAL OR BANK) OR CASHIER’S CHECK ONLY.

Do you have community service work to perform?

9 Yes

9 No

Number of hours completed this month:

Number of hours missed:

Balance of hours remaining:

Do you have drug, alcohol, or mental health aftercare? 9 Yes 9 No

If yes, did you miss any sessions during this month? 9 Yes 9 No

Did you fail to respond to phone recorder instructions?

 

9 Yes

9 No

If yes, why?

 

 

WARNING: ANY FALSE STATEMENTS MAY RESULT IN REVOCATION OF PROBATION, SUPERVISED RELEASE, OR PAROLE, IN ADDITION TO 5 YEARS IMPRISONMENT, A $250,000 FINE, OR BOTH.

(18 U.S.C. § 1001)

I CERTIFY THAT ALL INFORMATION FURNISHED IS COMPLETE AND CORRECT.

SIGNATURE

DATE

REMARKS:

RECEIVED

MailOC

HCCC

RETURN TO:

U.S. Probation Officer

Date

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