You are here
All Forms
COMMUNITY SERVICE PROGRAM - Balance Sheet
Form for keeping track of your community service hours
COMMUNITY SERVICE PROGRAM - Referral Form
Referral form from the probation office to be given to the community service provider.
FINANCIAL DISCLOSURE STATEMENT
The purpose of this form is to determine what assets you may have or are in control of . If you are married or have a live-in companion, you must list assets held by your spouse or companion, as well as yourself, and show whether each asset is owned individually or jointly. By completing and signing this financial disclosure statement, you acknowledge that the information provided will affect action by the United States Department of Justice and further understand that any false answers can lead to the termination or nullification of any plea agreement ultimately reached and/or prosecution for false statements as provided under Title 18, United States Code, Section 1001 (maximum prison sentence of five (5) years and/or a fine of not more than $250,000).
DECLARACIÓN FINANCIERA COMPLETADA POR EL ACUSADO
El intento de ésta declaración es para determinar cuales bienes tiene realmente y/o bienes a su mando. Si usted está casado o si está en una relación co-habitante, usted tiene que listar los bienes de su cónyuge o co-habitante, más los bienes suyos, y tiene que establecer especificadamente a quien le pertenece los bienes sea independiente o conjuntamente poseídos. En completar y firmar ésta declaración financiera, usted certifica que la información proveida afectará la ación del Departamento de Justicia de los Estados Unidos y usted comprende que cualquier respuestas falsas pueden resultar en la terminación o anulación de qualquier acuerdo de declaración y/o prosecución por declaración falsa proveida bajo Título 18, Código EE. UU., Sección 1001 (condena maxima de cinco años y/o multa de menos de $250,000).
Net Worth Statement
Having been convicted in the United States District Court, you are required to prepare and file with the probation officer an affidavit fully describing your financial resources, including a complete listing of all assets you own or control as of this date and any assets you have transferred or sold since your arrest. Amendments were made to 18 U.S.C. §§ 3663(a)(1)(B)(i), 3664(d)(3), and 3664(f)(2), and Rule 32(b)(4)(F) to clarify that the assets owned, jointly owned, or controlled by an offender, and liabilities are all relevant to the court’s decision regarding the ability to pay.
Your Net Worth Statement should include assets or debts that are yours alone (I-Individual), assets or debts that are jointly (J-Joint) held by you and a spouse or significant other, assets or debts that are held by a spouse or significant other (S-Spouse or Significant Other) that you enjoy the benefits of or make occasional contributions toward, and assets or debts that are held by a dependent (D-Dependent) that you enjoy the benefits of or make occasional contributions toward.
Net Worth Statement - Limited Information Version
Having been convicted in the United States District Court, you are required to prepare and file with the probation officer an affidavit fully describing your financial resources, including a complete listing of all assets you own or control as of this date and any assets you have transferred or sold since your arrest. Amendments were made to 18 U.S.C. §§ 3663(a)(1)(B)(i), 3664(d)(3), and 3664(f)(2), and Rule 32(b)(4)(F) to clarify that the assets owned, jointly owned, or controlled by an offender, and liabilities are all relevant to the court’s decision regarding the ability to pay.
Your Net Worth Statement should include assets or debts that are yours alone (I-Individual), assets or debts that are jointly (J-Joint) held by you and a spouse or significant other, assets or debts that are held by a spouse or significant other (S-Spouse or Significant Other) that you enjoy the benefits of or make occasional contributions toward, and assets or debts that are held by a dependent (D-Dependent) that you enjoy the benefits of or make occasional contributions toward.
Contact Log of Job Applications