Inventory Of Special Conditions Of Probation Template (Page 5 of 5) in pdf

Inventory Of Special Conditions Of Probation Template Page 5

Other special condition(s). The Defendant shall abide by the following

additional special condition(s): _______________________________________

________________________________________________________________

SO ORDERED this ________day of _____________________, 20______.

___________________________________________

Judge of Superior Court

_______________________________ Judicial Circuit

___________________________________________

(print or stamp Judge’s name)

Acknowledgment: I have read the terms of this document or had them read and

explained to me. I understand that violation of a special condition of probation could

result in revocation of all time remaining on the period of probation.

___________________________________

Defendant

State of Georgia v. ____________________

Criminal Action # _____________________

SC-6.4(B) Inventory of Special Conditions of Probation

Page 5 of 5

Inventory Of Special Conditions Of Probation Template Page 5