Tri City Online Reporting

Tri City Probation Online Reporting Form

If you were instructed by your officer to report online, please fill out the form below. If you did not receive permission to report online, then you need to contact your officer via email to clarify how you are to report. If you report online without permission it will not count as reporting and additional actions may be taken on your case.

Probation Officer

Offender Number# (TN):

First Name

Middle

Last name

Date Of Birth

Phone

Address

City

State

Zip/Postal

Address

Mailing Address (If different)

City

State/Province

Zip/Postal

Mailing Address (If different)

Occupation

Employer

Employer Phone

Employer’s Address

Employer's Address

City

State/Province

Zip/Postal

Employer's Address

Supervisor’s Name

If absent from work, please list how many days and the reason for not working

Amount Earned This Month:

I am gainfully employed and can provide proof by uploading a current pay stub

Please upload your pay stub here

Maximum file size: 67.11MB

If no, please explain:

Please answer the following questions

You may only answer N/A if this was not a part of your sentence or if the condition is complete.

1. Do you fully understand the conditions of your probation?

2. Did you violate any condition of your probation this month?

If Yes, Please Explain:

3. Do you have a “no contact”, “no violent contact”, or “stay away from”Condition?

A. If yes, who or what location are you to have no contact/violent contact with?

B. Did you violate this condition of your probation?

4. Did you change your Residence this month?

5. Did you change your employment this month?

6. Were you arrested or issued a ticket this month?

If Yes, please explain the circumstances of the arrest or ticket

7. Do you have a valid driver’s license and insurance?

8. Did you drive a motor vehicle this month?

9. Did you use alcohol or drugs this month?

If Yes, Please Explain:

10. Did you use any weapons or firearms this month?

11. Did you attend school this month?

12 Did you attend a program for anger, mental health, alcohol, drugs, or otherthis month?

A. If yes, which program

Will complete on

13. Did you perform any community service work this month?

If yes, how many hours did you do this month?

14. Did you make a payment this month?

Amount Paid

Money Order Type

Money Order #

15. If no payment was made, why not?

CERTIFICATION

I HEREBY CERTIFY THAT I HAVE ANSWERED ALL THE FOREGOING QUESTIONS TRUTHFULLY AND TO THE BEST OF MY KNOWLEDGE

Signature

Clear

Date

File Upload

Maximum file size: 67.11MB