Misdemeanor Probation

COMMISSIONERS

A valid email address must be provided. All areas that indicate the * will need to be addressed, if some of the areas do not apply answer with N/A

Email*
Date
MM slash DD slash YYYY
Probation Officer:
Name
First Last
Date of Birth:
MM slash DD slash YYYY
Is this a new address?
- Yes
- No
Current or Physical Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Mailing address if different from current or Physical
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Home Phone:
Cell Phone:
Employer:
Employer's Phone:
Are you currently attending any programs as required by the Court or your PO?
- Yes
- No
If yes, name of provider/program:
Do you have any treatment absences this month?
- Yes
- No
If yes, when and why?
Have you paid on any of your fines this month?
- Yes
- No
If yes, how much did you pay?
Have you had any contact with police? If yes, please explain:
Please indicate date, and if you were: Arrested, Cited, or Questioned
Have you used any illegal drugs, alcohol, or mood altering substances since your last visit? If yes, please explain:
Please indicate date and type of use
What are your goals for the month?
Signature*
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Name
This field is for validation purposes and should be left unchanged.

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222 North 12th Avenue
Caldwell, ID 83605

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P 208-454-7260
F 208-454-7258
Community Service 208-455-6002

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Weekdays 8am – 5pm
*Closed for lunch 12pm-1pm
(excluding holidays)