Free Probation Form 12B - District Court of Connecticut - Connecticut

i
i F0rm12B Case 3:00-cr-00094-CFD Document 36 Filed 08/14/2007 Page 1 of 2
UNITED STATES DISTRICT COURT
DISTRICT OF CONNECTICUT
i U.S.A. vs. THOMAS DAvis Docket No. 3:00CR00094(CFD)
i Petition For Modification of Conditions or Term of Probation/Supervised Release - »
with the Consent of the Offender I
COMES NOW, Jennifer Amato, PROBATION OFFICER OF THE COURT, presenting an official report upon the
conduct and attitude of Thomas Davis who was sentenced to 53 months' imprisonment for a violation of 18 U.S.C. 922(g)(1),
Felon in Possession of a Firearm by the Honorable Christopher F. Droney, U.S. District Judge sitting in the court in Hartford,
Connecticut on March 2, 2001, and imposed the general terms and conditions theretofore adopted by the court and also
imposed the special condition and terms as follows: 1) The defendant is prohibited from possessing a firearm or other
dangerous weapon and 2) The defendant is required to participate in a substance abuse program approved by the probation
officer.
Thomas Davis began supenrision on March 4, 2005 and his supervision is scheduled to expire on March 4, 2008.
RESPECTFULLY PRESENTING PETITION FOR ACTION OF COURT AND FOR CAUSE AS FOLLOWS:
PRAYING THAT THE COURT WILL ORDER that this petition will serve:
[I To extend the term of probation/supenrised release for years, for a total term of years.
I To modify the conditions of supervision as follows:
The defendant shall participate in a program of mental health treatment to include either inpatient or outpatient
treatment. The defendant shall pay all of or a portion of the costs associated with treatment based on his ability to pay, as
approved by the U.S. Probation Office.
ORDER OF COURT Q Respectfuyy Submitt 7, »
Consid Fdered this M C-- A- in J ·‘‘'-4- U i~’&”
day of Mey:2007 nd ordere iled and made a part of the Jennifer Amato
records in thyagycase. . Seni r United States Probation Officer
TF Place: Hartford, Connecticut
e i-tonocaule 'hristopher F. Droney'"' _ , ‘ _
United States I5-strict Judge Date;
[IJ z-

Case 3:00-cr-00094-CFD Document 36 Filed 08/14/2007 Page 2 of 2
i PROB 49
(3/89)
Zielnitrzb rétatrzs Zilrstrrct QKr:rurt
District of Connecticut
Waiver of Hearing to Modify Conditions of Supervised Release or Extend Term of Supervision
I have been advised and understand that I am entitled by law to a hearing and assistance of counsel
before any unfavorable change may be made in my Conditions of Probation and Supervised Release or my
period of supervision being extended. By "assistance of counsel," l understand that l have the right to be
represented at the hearing by counsel of my own choosing ifl am able to retain counsel. l also understand that
l have the right to request the court to appoint counsel to represent me at such a hearing at no cost to myself
if l am not able to retain counsel of my own choosing.
I hereby voluntarily waive my statutory right to a hearing and to assistance of counsel. l also agree to
the following modification of my Conditions of Probation and Supervised Release orto the proposed extension
of my term of supervision:
The defendant shall participate in mental health treatment as approved by the probation office. The
defendant shall pay all of or a portion of the costs associated with treatment based on his ability to pay in an
amount determined by the probation officer.
//
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Witness J signed ;iiQ"~=‘r~r*·/as <~-»*’=
Je nifer Ama b Thomas Davis
U.S. robation Officer Supervised Releasee
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