Connecticut > Statewide > Criminal
Application For Supervised Diversionary Program JD-CR-154 - Connecticut
| Application For Supervised Diversionary Program Form. This is a Connecticut form and can be used in Criminal Statewide . |
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APPLICATION FOR SUPERVISED DIVERSIONARY PROGRAM JD-CR-154 Rev. 5-11 C.G.S. § 54-56l Notice to Clerk: Seal the file on order of the court per C.G.S. § 54-56l www.jud.ct.gov Instructions to Applicant 1. Complete Section I. 2. Keep the goldenrod copy for your records. Instructions to Clerk 1. Retain white copy in the court file. 2. Give yellow copy to CSSD and pink copy to the State's Attorney. Section I TO: The Superior Court of the State of Connecticut Geographical Area number Address of court Sex CMIS number Docket number Name of applicant/defendant Year of birth Female Address of applicant (Number, street, town and apartment number) Male Telephone number I have a psychiatric disability that is a mental or emotional condition that is not just substance abuse. Without proper care and treatment, the psychiatric disability strongly sets back (has substantial adverse effects on) my ability to function. I have been accused of one or more crimes or one or more motor vehicle violations which could result in a jail sentence. The crimes or violations are not serious. I am applying for the Supervised Diversionary Program. If my application is granted, I agree to the following: 1. To give the state more time to prosecute me (the tolling of any statute of limitations and waiver of the right to a speedy trial for such crime) if I do not successfully finish the Program. 2. To any condition that may be set up by the Court Support Services Division (CSSD) about my taking part in the Supervised Diversionary Program including conditions about my taking part in meetings, treatment or sessions of the Program. I give my permission to the Court Support Services Division to get information about my prior participation in the Supervised Diversionary Program or my eligibility to participate in the pretrial program for accelerated rehabilitation under General Statutes § 54-56e(c). I understand that details of my mental or emotional condition or substance abuse issues may be made known to the court and may become part of my court file. By signing this form, I am saying that I understand all of the above and I request that I be granted the Supervised Diversionary Program (C.G.S. § 54-56l). I have read or have had the above read to me and I understand it. Signed (Applicant, or Parent or Guardian if applicant is minor) Date signed Section II Oath The applicant stated under penalties of perjury before me, duly designated by the clerk and authorized to administer oaths, that (s)he has not previously participated in the Supervised Diversionary Program established under C.G.S. § 54-56 l more than once. Signed (Duly authorized person) Print name of person signing at left Date signed Distribution: White -- Court file Yellow -- CSSD Pink -- State's Attorney (Page 1 of 2) Goldenrod -- Applicant American LegalNet, Inc. www.FormsWorkFlow.com First Order of Court ("X" ALL THAT APPLY) (If the application is denied and the file ordered unsealed, consider ordering the applicant's telephone number redacted.) The foregoing application is denied. The applicant's oath under C.G.S. § 54-56 was taken in open court. The foregoing application is granted. The court orders the court file sealed as to the public and refers the applicant to CSSD for confirmation of eligibility and assessment of the applicant's mental health condition. The State's Attorney shall provide CSSD with a copy of the police report. at (date) (time) Date signed The case is continued until Signed (Judge, Assistant Clerk) a.m./p.m. Court Support Services Division Assessment and Confirmation Prior participation in Supervised Diversionary Program One Time Two Times No Yes No Eligible for Accelerated Rehabilitation under subsection (c) of General Statutes § 54-56e Assessment Signed (Judge, Assistant Clerk) Eligible Ineligible Date signed Second Order of Court (If the application is denied and the file ordered unsealed, consider ordering the applicant's telephone number redacted and the victim notification (JD-CR-153) sealed pursuant to Practice Book § 42-49A; and not ordering the clinical needs assessment and/or treatment plan submitted on or with the JD-AP-149 unsealed.) The court, having determined that the defendant is ineligible, denies the foregoing application and the court file is ordered to be unsealed, a plea of not guilty entered and this case to be immediately placed on the trial list. Based upon the information provided by the Court Support Services Division, the court finds that appropriate services and treatment are not available for this defendant at this time. The court, upon confirmation of the defendant's eligibility and after considering the treatment plan presented by the Court Support Services Division for this defendant, grants the foregoing application and the applicant is referred to the Court Support Services Division for supervision pursuant to the Supervised Diversionary Program. The case is continued until (date) Signed (Judge, Assistant Clerk) at (time) a.m./p.m. Date signed Final Progress Report The Defendant has satisfactorily completed the assigned program. The Defendant has not satisfactorily completed the assigned program because (Explain): Signed (CSSD Officer) Date signed Disposition (If the court file is ordered to be unsealed and a plea of not guilty entered, consider ordering the applicant's telephone number redacted and the victim notification (JD-CR-153) sealed pursuant to Practice Book § 42-49A; and not ordering the clinical needs assessment and/or treatment plan submitted on or with the JD-AP-149 unsealed.) Program satisfactorily completed and charges dismissed. Program not satisfactorily completed because (Explain): The court file is to be unsealed, a plea of not guilty entered and this case to be immediately placed on trial list. Signed (Judge, Assistant Clerk) Date signed JD-CR-154 Rev. 5-11 (Page 2 of 2) American LegalNet, Inc. www.FormsWorkFlow.com
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