Suffolk County Department of
Probation
Request for Information
Use this form to request a letter from the Suffolk County Department of Probation regarding the time
under supervision.
Mail or FAX this form to:
Suffolk County Probation Department,
PO Box 188, Yaphank, NY 11980
FAX (631.852.5103)
Reason for Request
Probationer Information
Full Name:
Last
First
M.I.
Address:
Street Address
Apartment/Unit #
State
ZIP Code
Home Phone:
Alternate Phone:
Email:
Birth Date:
Signature:
Reason for the Letter:
click to sign
signature
click to edit