Form Ao 199b - Additional Conditions Of Release
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1AO 199B (Rev. 12/11) Additional Conditions of Release
Page
of
Pages
ADDITIONAL CONDITIONS OF RELEASE
IT IS FURTHER ORDERED that the defendant’s release is subject to the conditions marked below:
(
) (6)
The defendant is placed in the custody of:
Person or organization
Address
(only if above is an organization)
City and state
Tel. No.
who agrees to (a) supervise the defendant, (b) use every effort to assure the defendant’s appearance at all court proceedings, and (c) notify the court immediately
if the defendant violates a condition of release or is no longer in the custodian’s custody.
Signed:
Custodian
Date
(
) (7)
The defendant must:
(
) (a) submit to supervision by and report for supervision to the
,
telephone number
, no later than
.
(
) (b) continue or actively seek employment.
(
) (c) continue or start an education program.
(
) (d) surrender any passport to:
(
) (e) not obtain a passport or other international travel document.
(
) (f) abide by the following restrictions on personal association, residence, or travel:
(
) (g) avoid all contact, directly or indirectly, with any person who is or may be a victim or witness in the investigation or prosecution,
including:
(
) (h) get medical or psychiatric treatment:
(
) (i) return to custody each
at
o’clock after being released at
o’clock for employment, schooling,
or the following purposes:
(
) (j) maintain residence at a halfway house or community corrections center, as the pretrial services office or supervising officer considers
necessary.
(
) (k) not possess a firearm, destructive device, or other weapon.
(
) (l) not use alcohol (
) at all (
) excessively.
(
) (m) not use or unlawfully possess a narcotic drug or other controlled substances defined in 21 U.S.C. § 802, unless prescribed by a licensed
medical practitioner.
(
) (n) submit to testing for a prohibited substance if required by the pretrial services office or supervising officer. Testing may be used with random
frequency and may include urine testing, the wearing of a sweat patch, a remote alcohol testing system, and/or any form of prohibited
substance screening or testing. The defendant must not obstruct, attempt to obstruct, or tamper with the efficiency and accuracy of prohibited
substance screening or testing.
(
) (o) participate in a program of inpatient or outpatient substance abuse therapy and counseling if directed by the pretrial services office or
supervising officer.
(
) (p) participate in one of the following location restriction programs and comply with its requirements as directed.
(
) (i) Curfew. You are restricted to your residence every day (
) from
to
, or (
) as
directed by the pretrial services office or supervising officer; or
(
) (ii) Home Detention. You are restricted to your residence at all times except for employment; education; religious services; medical,
substance abuse, or mental health treatment; attorney visits; court appearances; court-ordered obligations; or other activities
approved in advance by the pretrial services office or supervising officer; or
(
) (iii) Home Incarceration. You are restricted to 24-hour-a-day lock-down at your residence except for medical necessities and
court appearances or other activities specifically approved by the court.
(
) (q) submit to location monitoring as directed by the pretrial services office or supervising officer and comply with all of the program
requirements and instructions provided.
(
) You must pay all or part of the cost of the program based on your ability to pay as determined by the pretrial services office or
supervising officer.
(
) (r) report as soon as possible, to the pretrial services office or supervising officer, every contact with law enforcement personnel, including
arrests, questioning, or traffic stops.
(
) (s)
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