Revocation Order

IN THE CIRCUIT COURT OF WILLIAMSON COUNTY, TENNESSEE REVOCATION ORDER Case Number ____________________________ Count #: ______ Attorney for State _______________________________ Judicial District: ________ Judicial Division: ________ Counsel for Defendant ____________________________________ Retained Appointed Public Defender State of Tennessee vs Defendant ____________________________________________________ Alias ________________________________ Date of Birth _________________________ Sex ______ Race ________ SSN: _________________________________ On the ___________ day of _______________________, 200___, X__________________________________________ Defendants signature ­ required for waiver { } "By Agreement" of Counsel { } Waived hearing & admitted violation & to serve original sentence. { } Admitted the Violation & agreement of State; { } to be heard by Court { } in violation { } not in violation, warrant dismissed { } After hearing, the defendant is found to be; ** Convicted Offense _________________________________________________ ________________________________________________________________ ( ) FELONY ( ) MISDEMEANOR ** ORIGINAL SENTENCE LENGTH: ___________________________________________ _________________________________________________________________ { } Probation Revoked { } Full Revocation; Serve Original Sentence Imposed { } Partial revocation: Serve _______ years ________ months _______ days ­ { } (day for day) / { { } Workhouse { } T.D.O.C. { } County Jail } Remainder of Sentence: { } at ________%) { { } Probation { } Community Corrections { } Termination { } Transfer to Community Corrections Program { } Reinstate to Probation { } Re-Sentence to _____ yr ______ mo. _____days { } County Jail { } Workhouse { } Terminated } T.D.O.C. } Community Corrections Revoked { } Full Revocation; Serve Original Sentence Imposed or as Modified { } Partial Revocation: serve _____ years _______ months ______ days { { } Remainder of Sentence: { } Probation } Reinstate to Community Corrections Program { } County Jail { { } Community Corrections { { } Transfer to Probation Credit for time served: } Community Corrections Program From _____/_____/_____ to _____/_____/_____. From _____/_____/_____ to _____/_____/_____. Total days credited _________________________________ SPECIAL CONDITIONS: ______________________________________________________________ ______________________________________________________________________________ ______________________ _________________________ ________________ JUDGE'S NAME JUDGE'S SIGNATURE DATE OF ENTRY _ __________________________________ ___________________________________ ATTY. FOR STATE {OPTIONAL} ATTY. FOR DEFENDANT {OPTIONAL} revised 2-03 American LegalNet, Inc. www.FormsWorkFlow.com