WRITTEN SUMMARY REPORT                                

Make Money Orders payable to:

     EFFINGHAM COUNTY PROBATION OFFICE

                                                                      902 NORTH PINE STREET
                                                                        SPRINGFIELD, GA 31329

                                                                                912-754-4155

                                                                                912-754-9136 (Fax)

 

 

YOUR PROBATION OFFICER: ___________________________________________

 

 

DATE: _____________________________TIME: ______________________

 

YOUR NAME: __________________________________________________

 

YOUR ADDRESS: __________________________________YOUR PHONE #: _________

 

YOUR EMPLOYER: _______________________________ WORK PHONE #: __________

 

YOUR WORK ADDRESS: __________________________________________________

 

COMMENTS: _________________________________________________________________________

 

___________________________________________________________________________

 

____________________________________________________________________________

 

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AMOUNT OF TODAY’S PAYMENT___________________RECEIPT#:____________

IF THE ABOVE WAS A PARTIAL PAYMENT, WHAT IS THE DATE OF YOUR NEXT PAYMENT TO CATCH UP TO DATE: _________________________.

 

HAVE YOU BEEN ARRESTED OR IN ANY TROUBLE SINCE YOUR LAST REPORT____________________IF YES, EXPLAIN_______________________________

 

CONDITIONS ORDERED AS PART OF PROBATION:

                                              YES          NO

COMMUNITY SERVICE      __            __     HOURS COMPLETED TO DATE:______

DOMESTIC VIOLENCE       __           __      # 0F SESSIONS COMPLETED:________

JAILTIME                              __           __     # OF HOURS COMPLETED:________

DUI SCHOOL                        __          __      COMPLETED: _______

ALCOHOL/DRUG

TREATMENT                                  __            __     COMPLETED:_______

 

 

I UNDERSTAND THAT I HAVE BEEN GRANTED THE PRIVILEGE OF WRITING MY REPORT TODAY, ONLY IF I FOLLOW THIS REPORT UP WITH A TELEPHONE CALL TO MY PROBATION OFFICER AS DIRECTED.  912-754-4155               

 

                                                               

                                               

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                                                                            SIGNATURE OF PROBATIONER