Form Dcjs - 3208 - Standard Local Jail Commitment Order [dcjs 3208]
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1DCJS - 3208 (7/04)
STANDARD LOCAL JAIL COMMITMENT ORDER
STATE OF NEW YORK
DOCKET #_________________________________
COUNTY OF__________________________________________
DATE OF BIRTH____________________________
TOWN/VILLAGE/CITY COURT OF_________________________
NYSID #___________________________________
DATE OF ARREST__________________________
CCN______________________________________
THE PEOPLE OF THE STATE OF NEW YORK
V.
Defendant
_____________________________________________________
TO: Sheriff of____________________________________County
The above named defendant having been:
convicted of the most serious offense of ___________________________________________,
in violation of Section ______________________________Sub Div__________________of the
____________________________Law, a (Class________Misdemeanor) (Viloation) (Infraction);
OR
adjudicated a (Mandatory) (Discretionary) Youthful Offender;
It is hereby ORDERED that the defendant be sentenced to imprisonment in the_____________________________County
Correctional Facility for:
a DEFINITE term of ______________________days.
OR
an INTERMITTENT term of ____________________days;
said term to be served from____________(AM/PM) on_____________ (day) of each week until
_________ (AM/PM) on_________________(day) of each week, until the expiration of the term;
the first date of confinement shall be______________________________and;
the last date of confinement shall be___________________________ .
OR
a fine of $ _____________and imprisonment until the
fine is satisfied, or for a maximum period of __________________days.
AND
that the sentence herein shall run
consecutive to
OR
concurrent with (the undischarged portion of)
the sentence imposed on the defendant on______________ by ___________Court.
The Commitment also satisfies the following charges:
CCN
Court
Arresting Agency
Date of Arrest
Charge
Docket Number
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
SPECIAL ORDERS/INSTRUCTIONS
a period of probation,
1 Year or
3 Years
Sentenced more than 90 days, (Presentence Report attached)
Additional Comments________________________________________________________________
Sex Offender
MANDATORY SURCHARGE INFORMATION/CRIME VICTIMS ASSISTANCE FEE (CVAF)
Pursuant to Section 60.35 of the Penal Law of the State of New York a mandatory surcharge in
the amount of $_______and/or a crime victim assistance fee in the amount of $_______has been
imposed, and in accordance with Section 60.35 (5) your are hereby notified that the defendant
has failed to pay the mandatory surcharge and/or crime victim assistance fee as of this date.
DATED:______________
_____________________________________
Signature of Judge or Justice
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