FORM 9. (N.D.R.Crim.P.)

APPENDIX "A"

CONDITIONS FOR SENTENCE TO PROBATION, DEFERRED OR SUSPENDED SENTENCE IN THE CASE OF

State vs. _______

Criminal Case No. ________—_______ County

By Order of the Court:

While you are on probation, you must not:

( ___ )1. Violate any criminal law or ordinance. This includes any violation of a federal, tribal, state, county or municipal criminal law or ordinance.
( ___ ) 2. Use or possess any type of firearm, destructive device or dangerous weapon.
( ___ ) 3a. Use or possess any alcoholic beverage or enter any place licensed to sell or serve alcoholic beverages.
( ___ ) 3b. Use alcohol to excess. Excessive use of alcohol is presumed if you have an alcohol concentration of ___ percent or greater.
( ___ ) 4. Use or possess a controlled substance that has not been prescribed for you or mis-use any controlled substance that has been prescribed for you.
( ___ ) 5. Use or possess surveillance equipment or counter surveillance equipment.
( ___ ) 6. Have any contact with __________. This includes telephone, written, and electronic communication and contact through other people.
( ___ ) 7. Come within ___ yards of __________ or (his) (her) residence.
( ___ ) 8. Willfully defraud a urine test administered as a condition of probation.

While you are on probation, you must:

( ___ ) 9. Report to the probation office within 24 hours of sentencing or release from custody.
( ___ ) 10. Stay in regular contact with your probation officer as you are instructed by the probation officer. You must have the approval of your probation officer before you change your address. You must inform your probation officer of any change of employment, or telephone number. You must be truthful with your probation officer.
( ___ ) 11. Allow your probation officer to visit your residence or place of employment.
( ___ ) 12. Allow your probation officer or other probation officers to search your person, place of residence, vehicle, or other property you have control over at any time of the day or night even if the probation officer doesn't have a search warrant. Your probation officer may request assistance of law enforcement officers to conduct a search.
( ___ ) 13. Continue with your present employment or seek and maintain suitable employment. You may attend school or training that will help you find better employment.
( ___ ) 14. Allow medical examination or other testing for the purpose of determining if you have used alcohol or controlled substances. This includes testing of breath, blood, saliva, urine or sweat.
( ___ ) 15. Have a chemical addiction evaluation or other diagnostic evaluation and follow any treatment recommendations. You may ask for a hearing if you disagree with treatment recommendations.
( ___ ) 16. Waive extradition to North Dakota if you are arrested outside of North Dakota.
( ___ ) 17. Provide support for your dependents.
( ___ ) 18. Pay the following:

a. Fine: ___;
b. Court-appointed attorney fees: ___;
c. Court fees : ___;
d. Restitution: ___;
e. Victim assistance fees : ___;
f. Other : ___.

( ___ ) 19. Pay a monthly supervision fee in the amount of $ 55 for probation supervision.

( ___ ) 20. Pay $ 50 for preparation of the pre-sentence investigative report.
( ___ ) 21. Be fingerprinted.
( ___ ) 22. Provide a sample of blood or other body fluid for DNA law enforcement purposes and pay the cost of collecting and processing the DNA sample.
( ___ ) 23. Successfully complete:

___ a. A cognitive restructuring program if your probation officer asks you to do so.
___ b. Domestic violence offender treatment.
___ c. An anger management program.
___ d. ___ hours of community service.

( ___ ) 24. Participate in electronic monitoring and follow all of the rules of the electronic monitoring system as required by your probation officer.
( ___ ) 25. Complete any intermediate condition which you agree to complete to avoid revocation of probation.

While on probation you must have the written approval from your probation officer before you:

( ___ ) 26.
___ a. Associate with anyone you know to be a felon.
___ b. Associate with known drug users or traffickers.
___ c. leave North Dakota.
( ___ ) 27. Other conditions of probation: __________.

The following are sex offender conditions.

While you are on probation, you must:

(___) 28. Attend, participate in, cooperate with and successfully follow and complete all sex offender treatment program rules and requirements and admit responsibility for your offense(s) as part of the treatment requirements. This includes attending aftercare if recommended by the parole/probation officer or treatment staff.
(___) 29. Submit to any program of psychiatric, psychological or physiological assessment approved by the court and be financially responsible for all costs related to any assessments, polygraphs and treatment programming ordered by the court.
(___) 30.
a. Register as a sex offender or an offender against children within three days after the date of your criminal judgment or your release from custody.
b. Register with the chief of police in the city or sheriff of the county where you live and inform them in writing where you live, where you work and where you go to school.
c. If you work or go to school in a different city or county or state from where you live, register with the chief of police in the city or sheriff of that county.
d. If you plan to change your name, inform the police or sheriff in writing at least 10 days before the change. When your name change takes effect, inform the police or sheriff in writing within three days.
e. If you change your vehicle information, e-mail address, or online name while on probation, tell the police or sheriff within three days after the change.
f. If you plan to change your school, or job, or to move, inform the police or sheriff in the city or county where you are currently registered in writing at least 10 days before the change.
g. If you change your school or job, or if you move, register with the police or sheriff in the new city or county where you go to school, work, or live within three days after the change.
(___) 31. Reside only at a place of residence approved by your parole/probation officer.
(___) 32. Maintain employment at only such places as are approved by your parole/probation officer.
(___) 33. Notify your parole/probation officer of any new and existing romantic or sexual relationships in which you may be involved.

While you are on probation, you must not:

(___) 34. Initiate, establish or maintain contact, directly or indirectly, with any child under the age of 18, or attempt to do so, except under circumstances approved in advance and in writing by your parole/probation officer.
(___) 35. Go to or loiter near schoolyards, parks, playgrounds, arcades, or other places primarily used or visited by minors.
(___) 36. Purchase, possess, or use sexually stimulating materials of any kind or use 900 telephone numbers.
(___) 37. Subscribe to any Internet service provider, by modem, LAN, DSL or any other manner or use another person's Internet or use Internet through any commercial venue until and unless approved in writing by your parole/probation officer.
(___) 38. Possess children's items, including, but not limited to, children's clothing, toys, games, pictures and books, without written permission from your parole/probation officer.
(___) 39. Date or socialize with anybody who has children under the age of 18 without written permission of your parole/probation officer.
(___) 40. Obtain employment with any agency or place of business that provides services for the care or custody of minors and you must not operate a business that provides such services without written permission of your parole/probation officer.
(___) 41. Work outside the State of North Dakota or leave the State of North Dakota without permission under the Interstate Compact for the Supervision of Adult Offenders.
(___) 42. Move from your place of residence or sleep elsewhere overnight without your parole/probation officer's knowledge and permission and without informing those with whom you reside that you are a sex offender.

Detailed Employment and Visitation Conditions for Sex Offenders:

(___) 43. You may travel to __________ each day for employment, provided the employment is regular and the employer requires you to work in __________. You may be in __________ only for employment purposes during scheduled working hours and you must return to __________ immediately after the completion of work each day. You may not be in or remain in __________ for any purpose except for employment and to travel to and from employment. You must register as a sex offender in __________.
(___) 44. You may travel to __________ for visitation with __________, provided that there are no minor children in the __________ household at the time of visitation. You may be in __________ only for visitation purposes and may on be at __________ residence and you must return to __________ immediately after completion of visitation. You may not be in or remain in __________ for any purpose except for visitation. You must register as a sex offender in __________.
(___) 45. Other sex offender conditions___________.

BY THE COURT,
Date:

__________.
JUDGE

The conditions of probation have been explained to me. I agree to follow the conditions which are listed and checked. I know that if I don't follow the conditions of probation, my probation may be revoked and I could be re-sentenced to any sentence which could have been imposed at the time I was sentenced.
Date:

____________________________________
Probationer

The conditions of probation have been explained to my client by the Judge. My client has indicated (he)(she) understands the conditions of probation.
Date:

__________.
Defense Attorney