Teen Court Community Service Log Template

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Teen Court Community Service Log
FINE AMOUNT $_______________________
# HOURS DUE ________________________
(please print)
DATE DUE ____________________________
NAME______________________________________
Date
Hours
Name of Non-Profit
Phone
Supervisor’s Signature
Supervisor’s Printed Name
Organization/Location
Total Hours
This reflects a correct record of my community service hours worked as required by the court for:
Docket # ___________________________________
__________________________________________________
___________________________________
Defendant Signature
Date
MUST BE TOTALED, SIGNED, AND DATED TO BE ACCEPTED
Community Service must be performed for a non-profit organization OR a governmental entity.
Hours performed for a for-profit business WILL NOT be accepted.
Hours must be supervised and the supervisor’s name and telephone number must appear on the time sheet.
Parents and/or relatives may not supervise these hours. If the supervisor’s name and telephone number is not
legible on the form, you may not receive credit. Hours will be verified. Hours must be totaled and turned in on
the form provided by the Teen Court Coordinator, Stacey Warner, 512-943-1594.
11/19/2013

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