Fill and Sign the Docket Amp Disposition Report Form

District Court STATE OF VERMONT Form No.392 V. Docket & Disposition ReportViolation of Probation Docket No. DISTRICT COURT OF VERMONT VOP Defendant Unit No. M.I. FirstIncident Offense No. Last Name Circuit DMV Use Address Scheduled Date of Appearance Place of Birth Age Date of Birth City, State, Zip Code Probation Officer Office Location Place of Violation Date of Violation PreviousViolations Original Sentence: ALL SUSPENDED Date Judge PART SUSPENDED Original Offense Date of Arraignment Date of Rule 5 Hearing A R R A I G N Defendant Waives: Copy of Complaintto Defendant 24 Hour Rule Reading of Probable Cause Found M I Complaint E N T Right to Counsel Continued for Plea PRE-ARRAIGNMENT BAIL $ Amount Date Posted Date Set Date Set Date Posted Date Mitt. for Lack of Bail Amount Deposit Date Refunded Personal Recognizance Cash/Surety Conditions Appearance Bond Date Defendant's admission of violation is found by this court to be voluntary and made with knowledge and understandingof the consequences and after knowing waiver of constitutional rights Admission has a factual basis. Said admissionis hereby accepted and a finding of violation entered hereon. Finding of No Violation Dismissed by Court Finding of Violation JUDGE: Dismissed by State Admission of Violation Date Sentence Imposed Probation Continued Probation Conditions Probation Under Original Conditions Modified Revoked MAXIMUM MINIMUM with credit for: DAYS YEARS MONTHS to be served from: at Concurrent TO SERVE Consecutive to: at to Docket No.'s PART SUSPENDED beginning: ALL SUSPENDED Date of Disposition Date Disp.Report Sent Signature of Judge Date Mittmus Date Probation Warrant DMV Use Probation Discharge Date Signature of Clerk Date MINIMUM DAYS YEARS MONTHS MAXIMUM DAYS YEARS MONTHS TO SERVE DAYS YEARS MONTHS VIOLATION OF PROBATION Defendant Admits Violation Denies Violation Defendant's Attorney Pro Se Private CounselAssigned Counsel Denied Name of Judge Name of Reporter Name of Defendant's Attorney Name of Guardian ad Litem F A I L U R E T O APPEA RDate Judicial Summons to IssueArrest Warrantto Issue Bail Amount Date Judicial Summons Date Arrest Warrant Date Violation Hearing Att's. Appearance of Return by DAYS YEARS MONTHS DAYS YEARS MONTHS TERM SUSPENDED ON PROBATION ADDITIONAL OR MODIFIED CONDITIONS R U L E 5 BA IL D I SP S E N T E NC E Rev. 2/06 SML Distribution at Disposition: Original - Case File, Copies to: VCIC Probation Office AM PM AM PM