Montana Department of Justice
24/7 Sobriety Program
Date: ____________________
Testing Time (circle one): A.M. / P.M.
Participant Name: _______________________________
Participant DOB: _______________________________
Testing Location:
Helena Prerelease Center
805 Colleen Street
Helena, MT 59601
Lewis & Clark County Detention Center
221 Breckenridge Street
Helena, MT 59601
Participant has been ordered to participate in the 24/7 Sobriety Program as a condition of
bond or pretrial release, as a condition of a suspended sentence or probation, or as a
condition of parole. Participant has violated the 24/7 Sobriety Program condition in the
following manner:
Failed the PAST
1st PAST: ____________ %; Time: ____________
2nd PAST: ____________ %; Time: ____________
Failed to appear for a breath test
Failed to enroll
Failed to complete orientation
Presence of alcohol detected by a SCRAM device
Tampered with a SCRAM device
Judge/Parole Officer: ______________________________
File #: ______________________________
Original Offense: ________________________________
Order Condition (circle one): Bond / Suspended or Probation / Parole / Other
Name of Person Contacted (County Attorney’s Office; City Attorney’s Office):
Enter Complete Address
Enter Complete Address
Enter Phone Number
Enter Phone Number
Comments: _____________________________________________________________
Signature of Technician Making Report: ______________________________________
A copy of the probable cause affidavit is attached to this Violation Form.