STATE OF LOUISIANA STATE OF LOUISIANA
VS. ______ JUDICIAL DISTRICT COURT
_________________ PARISH OF _________________
DOC # ________
DOCKET # ________
MOTION AND ORDER
FOR HEARING TO REVOKE PROBATION
Comes now _______________ , who, as an employee of the Louisiana Department of
Public Safety and Corrections, Division of Probation and Parole, Baton Rouge, presenting an
official report on the conduct and attitude of _______________ , hereinafter referred to as
“probationer”. To the best of his knowledge, probationer was convicted of the offense of
__________________ , in this court on ________ ___ , 20 ___ , which Judge _______________ ,
Section ____ , deferred execution of sentence, and placed probationer on probation for a period of
__ years, beginning on __________ ___ , 20 ___ in accordance with law, and that probationer has
violated the conditions of his probation in the following respects, to-wit:
Refrain from criminal conduct and pay a supervision fee to defray the costs of probation
supervision.
The probationer has violated this condition in that he admitted in court on
________ ___ , 20 ___ that he would fail a drug screen and that he has not made
any payments towards his supervision fees since being placed on probation on
__________ ___ , 20 ___ .
The Court has ordered you to pay a supervision fee of $ _____ per month and it is to
begin on ________ ___ , 20 ___ .
The probationer has violated this condition in that he has not made any payments
toward his supervision fees since being placed on probation on __________ ___ ,
20 ___ .
1. Make a full and truthful report at the end of each month.
The probationer has violated this condition in that he has failed to submit any
monthly supervision reports since being placed on probation on ________ ___ ,
20 ___ .
4. Permit the probation officer to visit you at home or elsewhere.
The Probationer has violated this condition in that he does not live at the address
he provided the Office of Probation and Parole making it impossible for his
probation officer to visit him at home.
5. Devote yourself to an approved employment or occupation.
The probationer has violated this condition in that he has failed to provide proof
of an approved employment or occupation since being placed on probation.
11. Perform community service work. ( ___ Hours)
The probationer has violated this condition of his parole in that he has failed to
provide proof that he has completed any of his community service hours since
being placed on probation.
12. Submit yourself to available medical, psychiatric, mental health, or substance
abuse examination or treatment or both when deemed appropriate and ordered to do so by
the Probation and Parole Officer.
The probationer has violated this condition in that he failed to get a substance
abuse evaluation within the first ___ days of his probation as ordered by the court
on __________ ___ , 20 ___ .
RESPECTFULLY,
________________
PROBATION & PAROLE OFFICER
ORDER OF THE COURT
Considering the above and foregoing report of the Probation and Parole Officer to the
effect that _______________ has violated the conditions of his probation, it is ordered that the
probationer appear before me in open Court at ____________________ LA on the
_____________ day of _____________________ 20 ___ , at _________ o’clock ___.m., to show
cause why his probation should not be revoked.
This done before me on the ___________ day of _____________________, 20 ___ , at
_________________________, Louisiana.
_________________ , SECTION _____ , JUDGE
___________________ PARISH
_____ JUDICIAL DISTRICT COURT
__________ ___ , 20 ___
Honorable ___________________ , Section ___
___ Judicial District Court
_______________
__________ , LA ______
RE: _______________
DKT: __________
DOC#: __________
DOB: ____________
Dear Judge ___________________ , Section ___ :
On __________ ___ , 20 ___ , the above named offender was sentenced for the offense of
_________________ . The offender’s expiration date is __________ ___ , 20 ___ .
The offender is detained in _________________ Parish Prison. The offender will not be
given a preliminary hearing.
Qther: On __________ ___ , 20 ___ the subject appeared in Your Honor’s court for a
Bench Warrant that was issued on __________ ___ , 20 ___ . On this date the subject admitted
that he would fail a drug screen. Your Honor recalled the Bench Warrant, issued a Probation
Hold, and set a revocation date of __________ ___ , 20 ___ .
If Your Honor desires other action, please advise.
Respectfully submitted,
_______________
Probation and Parole Agent
Attachments:
Motion & Order for Hearing to Revoke Probation
Useful tips for preparing your ‘Motion Order Hearing’ online
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FAQs
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The best way to complete and sign your motion order hearing form
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