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UTAH STATE DISTRICT JUVENILE COURT
PROBATION ORDER
STATE OF UTAH, In the interest of
Case Number:
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A minor under 18 years of age
It is hereby ordered that , hereafter “probationer”, is placed on probation under the
supervision of the probation department of this Court with the following conditions:
The probationer will obey all federal, state and local laws and ordinances; and will report
any arrests, citations or contact with law enforcement to the probation department within
two (2) working days.
The probationer will obey all lawful and reasonable requests of his or her parent(s),
guardian(s), or custodian(s) with whom he or she is living.
The probationer will obey the lawful and reasonable requests of the probation
department; and shall meet with the probation department as directed.
The probationer will comply with curfew as set by the probation department. Any
modifications of curfew will be at the discretion of the probation department.
The probationer will comply with house arrest as ordered by the Court or home restriction
as directed by the probation department.
The probation department may contact the probationer at his or her place of residence,
school, place of employment, or elsewhere as deemed appropriate.
The probationer will not make contact with the person(s) or business(es) he or she
victimized without the permission of the probation department.
The probationer will not use or possess any intoxicating substance without a doctor’s
prescription and, will not use any over the counter substance without parental permission
and notification to the probation department. The probationer will not knowingly be in
the presence of any person(s) selling, using, or possessing such substance. The
probationer will submit to random drug testing as requested by the probation department
and will be responsible for the cost of any tests that are positive for unauthorized or
illegal use. Any costs for confirmation will be assessed to the probationer.
Page 1 of 4
Name of Minor:
Case Number:
Probation Order
The probationer, if defined as a “restricted person” by UCA 76-10-503 will not possess a
dangerous weapon or firearm under any circumstances. The probationer, if not defined as
a “restricted person” will not receive, possess, transport, or have under his or her control
any dangerous instrument, weapon, or firearm except with the written consent of the
probation department for legitimate and supervised recreational purposes.
The probationer will submit to a random search of his or her person or anything under the
probationers ownership, possession or control upon the request of the probation
department. The probation department may search areas outside of the probationer’s
bedroom with the consent of the individual who has control of the dwelling or living
space.
The probationer will submit to being photographed. Pursuant to 53-10-403 U.C.A., the
probationer will submit to being fingerprinted and provide a D.N.A. sample, and unless
otherwise ordered by the court will be responsible to pay the associated fee for the
collection of the sample.
The probationer will attend school regularly unless lawfully released, in which case he or
she will attend vocational training or seek and maintain gainful employment. The
probationer will inform the probation department immediately of any school suspensions,
expulsions, or termination of employment.
The probationer will participate in any therapeutic treatment and/or program ordered by
the Court or directed by the probation officer.
The probationer will not associate with any known gang member, juvenile or adult on
probation, parole, or in the custody of the Division of Juvenile Justice Services or the
Department of Corrections except as approved by the probation department.
The probationer will not wear or possess gang/drug attire or gang/drug insignias.
The probationer will obtain permission from the probation department before he or she
marries; changes residence; enters military service; or makes a major purchase when he or
she has outstanding court ordered financial obligations unless authorized by the probation
department.
The probationer will not have any overnight visits while on probation unless approved in
advance by the probation officer. Non-custodial visitation will be allowed if approved in
advance by the probation officer and if the non-custodial parent has submitted to the
court's jurisdiction by signing the Probation Order.
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The probationer will obtain permission from the probation department before leaving the
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Name of Minor:
Case Number:
Probation Order
state of Utah or remaining away from his or her place of residence overnight or for any
extended period. If the probationer leaves the state of Utah without permission or is
involved in delinquent activity while away, he or she will voluntarily return upon request
of the probation department or by order of the Court.
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Special Condition: _______________________________________________________
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Special Condition: _______________________________________________________
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Special Condition: _______________________________________________________
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Special Condition: _______________________________________________________
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Name of Minor:
Case Number:
Probation Order
It is hereby further ordered that as the parent(s), guardian(s), or custodian(s) of the probationer
you will participate fully in the probation program and comply with the following conditions:
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You will notify the probation department immediately of any violations of the probation
order and/or court order.
You will attend meetings with the probation department, school officials, mental health
providers or others as directed and ensure transportation is provided.
You will authorize any reasonable search of your home to ensure the probationer’s
compliance with the conditions of probation.
You will be financially responsible for the probationer’s treatment and / or placement, if
applicable.
You will not modify any conditions of the probation order.
Dated this ________ day of _____________, 200___
__________________________________________
Judge
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Name of Minor:
Case Number:
UTAH STATE JUVENILE COURT
Statement of Understanding and Acknowledgment
The minor has been placed on probation by order of the Utah State Juvenile Court and will be
under the supervision of the Probation Department. The minor will remain on probation until an
order of the Court is issued terminating him or her from probation.
Willful failure to comply with the probation program or orders of the Court may result in the
minor, parent(s), guardian(s), or custodian(s) appearance before the Court for contempt, and
parties may be subject to being fined, incarcerated, or other sanctions imposed as deemed
appropriate.
The parent(s), guardian(s), or custodian(s) and minor understand the above and acknowledge
receiving a copy of the Probation Order.
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Minor
__________________
Date
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Parent/ Guardian/ Custodian
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Date
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Parent/ Guardian/ Custodian
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Date
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Probation Officer
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Date
HISTORY: EFFECTIVE MAY 1, 2005
Note: Board of Juvenile Court Judges
Trial Court Executives
Legal Counsel
Chief Probation Officer
JCPO Manual Committee
Approved
Approved
Approved
Approved
Approved
04/08/05
03/10/05
03/13/05
02/10/05
03/01/05
