AOC-SJ-10 Rev. 1-08 Page 1 of 1 Commonwealth of Kentucky Court of Justice
www.courts.ky.gov
Senior Judge Reporting Month
SENIOR STATUS PROGRAM MONTHLY REPORTING FORM
Program Year
ASSIGNMENT DATES Date of SJ Order Date Worked
county
JURISDIcTION SERvED court Division
Reason*
ASSIGNMENT
Further Action Required? If yes, please explain.
Total days worked for this month: _________________
Total days worked for current program year:
I, ________________________________________________________________________________, certify the above is true and correct. ___________________________________________________________ Senior Status Judge's Signature Date
*Submit the monthly reporting form by the 10th day of each month, even if no judicial service was rendered during the prior month, to: Senior Status Program Administrator, Kathy Peach, Administrative Office of the Courts, 100 Millcreek Park, Frankfort, KY 40601-9230.
*Legend for Reason for Assignment cc-caseload congestion; DP-Death Penalty; R-Recusal; I-Illness; Jc-Judicial college/Education/Training; Jv-Judicial vacancy; MT-Service on Judicial conduct commission; RR-Review of case File/Research; and O-Other.
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