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Fill and Sign the Fillable Online Cr 766 Dill Statement Regarding Community Work Form

Fill and Sign the Fillable Online Cr 766 Dill Statement Regarding Community Work Form

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Exempt From VRA Certif. CR -776 DILLINGHAM (10/01 )(cs ) AS 12.55.015(a)(6) STATEMENT REGARDING COMMUNITY WORK SERVICE AS 12.55.055 IN THE DISTRICT COURT FOR THE STATE OF ALASKA AT DILLINGHAM ( ) STATE OF ALASKA, ) ( ) CITY OF DILLINGHAM, ) ) Plaintiff, ) ) v. ) ) , ) ) Defendant. ) ) CASE NO. CR TO: Community Work Service Supervisor Please complete this form and return it to the court upon completion of community work service by the defendant. STATEMENT REGARDING COMMUNITY WORK SERVICE I certify that the above -named defendant has comple ted: hours of community work service. no community work service. Date Signature Print Name Agency RETURN THIS FORM TO: Address Dillingham Trial Courts PO Box 909 Phone Dillingham, AK 99576 I certify that on a copy of this statement of work completed was given to the defendant. Clerk:

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