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Fill and Sign the Cr 776 Pete Statement Regarding Community Work Service Form

Fill and Sign the Cr 776 Pete Statement Regarding Community Work Service Form

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Exempt From VRA Certif. CR -776 PETE ( 5/97 )(cs) AS 12.55.015(a)(6) STATEMENT REGARDING COMMUNITY WORK SERVICE AS 12.55 0.055 IN THE DISTRICT COURT FOR THE STATE OF ALASKA FIRST JUDICIAL DISTRICT AT PETERSBURG STATE OF ALASKA, ) ) Plaintiff, ) ) v. ) ) , ) ) Defendant, ) ) CASE NO. CR TO: Community Work Service Supervisor Please complete this form and re turn it to the court upon completion of community work service by defendant. STATEMENT REGARDING COMMUNITY WORK SERVICE I certify that the above -named defendant has completed: ______ hours of community work service. no community work service. Date Signature Print Name Agency RETURN THIS FORM TO: Petersburg Trial Courts PO Box 1009 Petersburg, AK 99833 I certify that on a copy of this statement of work completed was given to the defendant. Clerk :

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