Forms

RELEASES OF INFORMATION

OASAS Consent to Release of Information Concerning Chemical Dependence Treatment

Livingston County Basic Information Request

Release of Health Information Pursuant to HIPAA

Impaired Driver System (IDS)

IGNITION INTERLOCK DEVICE (IID) 

Vehicle Owner Affidavit

Vehicle Access and Operation by Others

Ignition Interlock Acknowledgement From Employer

Financial Disclosure Form

Special Conditions for Offender Owned Business Vehicle

Owner Authorization to Install IID

VICTIM FORMS

Victim Impact Statement-General

Victim Impact Statement-Correctional Facilities

Victim Impact Statement-Insurance Companies

Victim Impact Statement-Financial Institutions

Victim Impact Statement-Drug Task Force

Victim Impact Statement-Schools

Victim Change of Address Form

PRE-TRIAL

Initial Pre-Trial Questionnaire

INVESTIGATIONS

COMPAS Risk Assessment

Investigation Questionnaire

Adoption Questionnaire

SUPERVISION

Supervision Reporting Form (Mail-In)

COMPAS Risk Assessment

EHM Schedule Request

Initial Reporting Questionnaire

JUVENILES

PINS General Referral Form

PINS Truancy Referral

CERTIFICATE OF RELIEF 

Certificate of Relief Application

Certificate of Relief

COURTS

Court Disposition Form 

Court Order for Investigation

PSI Waiver

PPI Waiver

Adult Probation Transfer Form

Adult Interim Probation Transfer Form

MISCELLANEOUS

Intern Application