Youthful Offender Eligibility Application Motion And Order {JD-CR-14}

YOUTHFUL OFFENDER ELIGIBILITY APPLICATION, MOTION AND ORDER JD-CR-14 Rev. 2-17 C.G.S. §§ 54-76b, 54-76c P.B. § 39-33 STATE OF CONNECTICUT Instructions: www.jud.ct.gov 1. File original form with clerk of court. 2. Send a copy to CSSD, Adult Probation and the prosecutor in your case. 3. Keep a copy for your records. Docket number SUPERIOR COURT TO: The Judicial Authority of the State of Connecticut From (Name of defendant) Address of defendant Judicial District or Geographical Area Address of Court Name of attorney (Include Juris number) Crime(s) charged against the defendant (Include date and offense(s) committed) Application and Motion I, the Defendant listed above, ask that I be investigated to determine if I am eligible to be adjudged as a Youthful Offender under Chapter 960a of the Connecticut General Statutes that were in effect before January 1, 2006, and move that the court file be sealed as to the public. I make the following statements: 1. The crime(s) charged against me took place before January 1, 2006. 2. On the date the alleged crime(s) took place, I had reached the age of 16 years but had not reached the age of 18, or this case was transferred to the regular criminal docket pursuant to section 46b-127 of the Connecticut General Statutes, which was in effect at the time the crime(s) took place. 3. I am charged with a crime that is not a Class A felony or a violation of section 53-21(a)(2), 53a-70, 53a-70a, 53a-70b, 53a-71, 53a-72a or 53a-72b of the Connecticut General Statutes, 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. 4. I have not been convicted of a felony before. 5. I have not been adjudged as a serious juvenile offender or serious juvenile repeat offender, as defined in section 46b-120 of the Connecticut General Statutes, or as a Youthful Offender before. 6. I have not been afforded a pretrial program for accelerated rehabilitation under section 54-56e of the Connecticut General Statutes. I AGREE 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 Defendant listed above, declare under oath, that the statements above are true, knowing that any false statement about this application is punishable by law. Consented to by (Signature of Parent or Guardian) Date signed Signed (Defendant) Date signed Date signed Signed (Attorney for Defendant) Order The application for investigation is: Denied Granted IT IS 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 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 Date of offense File date For Court Use Only DEFENDANT IS INELIGIBLE for the following reasons: Defendant has an Adult Felony Conviction Prior use of Accelerated Rehabilitation Previous Youthful Offender Adjudication Other (Specify:) Signed (CSSD Officer/Duly authorized personnel) Date CMIS case number Prior serious Juvenile offense The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act (ADA). If you need a reasonable accommodation in accordance with the ADA, contact a court clerk or an ADA contact person listed at www.jud.ct.gov/ADA. American LegalNet, Inc. www.FormsWorkFlow.com ADA NOTICE