Free YOUTHFUL OFFENDER ELIGIBILITY, APPLICATION, MOTION AND ORDER - Connecticut

YOUTHFUL OFFENDER ELIGIBILITY APPLICATION, MOTION AND ORDER
JD-CR-14 Rev. 10-01 C.G.S. §§ 54-76b et seq., 54-76c Pr. Bk. Sec. 39-33

STATE OF CONNECTICUT SUPERIOR COURT
Distribute as follows: 1. Clerk of Court - Original 2. C.S.S.D. - Adult Probation 3. Prosecutor
DATE OF BIRTH PLACE OF BIRTH DOCKET NO. SEX SOCIAL SECURITY NO.

TO: The Judicial Authority of the State of Connecticut
FROM (Name of Accused) ADDRESS OF ACCUSED JUDICIAL DISTRICT OR G.A. ADDRESS OF COURT

CR ME(S) CHARGED AGAINST THE DEFENDANT (Include date and offense(s) committed)

NAME OF ATTORNEY (Include Juris no )

APPLICATION AND MOTION
I, the above-named Defendant, hereby make application that I be investigated to determine if I am eligible to be adjudged as a Youthful Offender under the provisions of Chapter 960a of the General Statutes, and move that the court file be sealed as to the public. I hereby make the following statements: 1. That on the date the alleged violations occurred, I had reached the age of 16 years but had not reached the age of 18 years as verified by my date of birth, specified above, or this case was transferred to the regular criminal docket pursuant to C.G.S. § 46b-127. 2. I am charged with a crime which is not a Class A felony or a violation of C.G.S. §§ 53-21(a)(2), 53a-70, 53a-70a, 53a-70b, 53a-71, 53a-72a or 53a-72b, except a violation involving consensual sexual intercourse or sexual contact between myself and another person who is thirteen years of age or older but under sixteen years of age. 3. I have not previously been convicted of a felony. 4. I have not previously been adjudged as a serious juvenile offender or serious juvenile repeat offender, as defined in C.G.S. § 46b-120, or as a Youthful Offender. 5. I have not previously been afforded a pre-trial program for accelerated rehabilitation under C.G.S. § 54-56e. I HEREBY CONSENT TO THE FOLLOWING: a. Physical and mental examinations, if necessary. b. Investigations and questioning. c. A trial without a jury, should a trial be held.
I, the above-named Defendant, declare under oath, that the foregoing statements are true, knowing that my false statement herein is punishable by law.
CONSENTED TO BY (Signature of Parent or Guardian) DATE SIGNED SIGNED (Defendant) DATE SIGNED DATE SIGNED

SIGNED (Attorney for Defendant)

THE APPLICATION FOR INVESTIGATION IS:

ORDER DENIED

GRANTED

IT IS HEREBY ORDERED THAT: PHYSICAL EXAMINATIONS MENTAL EXAMINATIONS be made of the Defendant and that investigations be made, to determine the Defendant's eligibility as a Youthful Offender, by the Court Support Services Division. It is also ordered that the Connecticut State Police, or any agency thereof, release any information they may have regarding prior Youthful Offender adjudication of said Defendant and to provide such information to the investigating officer. IT IS HEREBY FURTHER ORDERED that the court file in this case be sealed only as to the public and that further action thereon be held in abeyance until such examinations, investigations and questioning are completed.
BY THE COURT (Name of Judge) DATE ORDERED DATE INVESTIGATION DUE SIGNED (Judge or Assistant Clerk) DATE SIGNED

ELIGIBILITY REPORT
DEFENDANT IS ELIGIBLE DEFENDANT IS ELIGIBLE BUT HAS CHARGES PENDING DEFENDANT IS INELIGIBLE for the following reasons:

For Court Use Only
DATE OF OFFENSE FILE DATE

DATE OF BIRTH VERIFIED BY (Form of I.D )

DEFENDANT HAS AN ADULT FELONY CONVICTION (See attached record) PREVIOUS Y.O. ADJUDICATION PRIOR USE OF ACCELERATED REHABILITATION PRIOR SERIOUS JUVENILE OFFENSE JUVENILE RECORD ATTACHED OTHER (Specify:)
ELIGIBILITY REPORT PROVIDED BY DATE OF REPORT CLIENT NUMBER STATE I.D. NUMBER PART A DOCKET NUMBER

YOUTHFUL OFFENDER ELIGIBILITY - APPLICATION, MOTION, AND ORDER

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