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NEW YORK STATE COURTS
UCS-966
_________________________ COURT
Court Address: ______________________________________________________
Court Phone: ______________________ Court Fax: ______________________
Court e-mail: _____________________________________
The People of the State of New York
Probation Transfer Case Summary
vs.
Case Number:
CJTN:
NYSID:
AKA(s):
Motorist ID:
Address:
Arrest Date:
Phone:
Sex:
Arraignment Date:
White
□ Male □ Female Race: ______________________
DOB: ______________
Youthful Offender: □ Yes □ No
TAKE NOTICE that, by order of this court, probation supervision has been transferred to: ___________________________________
Charge
Weight
Conviction Charge
Conviction
Type
Conviction
Date
Sentence
Date
Sentence Imposed
□ Pled Guilty
□ Tried Found __________
__________
Guilty
□ Pled Guilty
□ Tried Found __________
__________
Guilty
□ Pled Guilty
□ Tried Found __________
__________
Guilty
Active Order
 Yes DNA
 Yes
of Protection:  No Collected:  No
Sex Offender Risk Level Determined on:
Driver’s License
Suspended:
 Yes
 No
Certificate of Relief from Civil
Forfeitures and Disabilities
_____________
Termination of
Suspension Fee Paid:
 Yes  No
If yes: Paid on ______________
Total Fines, Fees and Surcharges Imposed:
Total Fine, Fee and Surcharge Payments:
Balance Due:
Due Date:
Civil Judgment Ordered:
 YES  NO
Original Papers Have Been Filed With
and/or Issued By This Court:
Requested:
If yes:
 Granted
Risk Level Assigned:
Suspension
Lifted:
 Yes
 Denied
 Level 1
 No
on ______________
 Level 2  Level 3
 Yes  No
If yes: Lifted on ______________
___________________
If yes: Ordered on __________________
 Yes  No
If yes: Original papers  ARE  ARE NOT attached for consolidation with the original file of record.
Original Sentencing Court Information
Docket
Name
County
Address
Phone
e-mail
Contact Name
Phone
e-mail
Contact Name
Albany
Receiving Court History
#
Docket
Name
County
Albany
Albany
Albany
Albany
Address