FIFTH JUDICIAL DISTRICT OF PENNSYLVANIA
ALLEGHENY COUNTY ADULT PROBATION DEPARTMENT
Name ______________________________Docket Number _____________________ OTN_______________
GENERAL RULES AND CONDITIONS OF PROBATION, PAROLE AND INTERMEDIATE PUNISHMENT (INCLUDING EM)
ACKNOWLEDGEMENT FORM
1. YOU MUST REPORT TO YOUR ASSIGNED PROBATION OFFICER as required and/or allow your probation officer to visit you at your home.
If you do not know who your probation officer is, call (412) 350-2320 between 8:30 a.m. and 4:30 p.m. Monday through Friday. Our 24-
hour emergency contact number is (412) 350-0400.
2. YOU MUST OBEY ALL LOCAL, STATE AND FEDERAL LAWS.
3. YOU MAY NOT POSSESS ANY FIREARM, AMMUNITION, OR PROHIBITED OFFENSIVE WEAPON AS DEFINED IN 18 Pa. C.S.A. § 908 WHILE
YOU ARE UNDER COURT SUPERVISION. This includes on your person, in your residence or in your vehicle.
4. YOU MUST PAY ANY RESTITUTION, FINES, COSTS AND SUPERVISION FEES during the term of your court supervision.
5. UPON REASONABLE SUSPICION, PROBATION OFFICERS ARE AUTHORIZED TO SEARCH YOU, YOUR VEHICLE AND YOUR HOME WITHOUT
A WARRANT. Any weapons, illegal drugs/paraphernalia, intoxicants and/or contraband in your possession are subject to seizure.
6. YOU MUST NOTIFY THE PROBATION OFFICE IMMEDIATELY OF ANY CHANGE OF ADDRESS.
7. YOU MUST MAKE EVERY EFFORT TO OBTAIN AND MAINTAIN EMPLOYMENT - unless you have proof that you are disabled.
8. ABSOLUTELY NO TRAVEL OUTSIDE PENNSYLVANIA IS PERMITTED without the written permission of your probation officer. Offenders
who need to travel outside Pennsylvania must proceed through the interstate compact. Your probation officer can instruct you in regard
to the interstate compact process.
9. YOU MUST NOTIFY YOUR PROBATION OFFICER AT ONCE IF YOU ARE ARRESTED OR CITED BY THE POLICE. You must also inform the
arresting officer that you are under court supervision.
10. YOU MAY NOT USE OR POSSESS ANY CONTROLLED SUBSTANCES, unless legally prescribed for a legitimate medical or mental health need.
11. YOU ARE SUBJECT TO RANDOM DRUG AND ALCOHOL TESTING when ordered by your probation officer.
12. YOU MUST SUBMIT TO IDENTIFICATION PROCEDURES if requested by your probation officer. This could include fingerprinting,
photographing, DNA or other identification procedures.
13. YOU MAY BE REQUIRED TO UNDERGO AN ASSESSMENT TO DETERMINE YOUR SUPERVISION NEEDS - The probation department has been
granted permission by the Court to require you to engage in any services that our assessment tools indicate are related to your supervision
needs.
14. YOU MAY BE REQUIRED TO PARTICIPATE IN ANY PROGRAM THAT THE PROBATION DEPARTMENT DEEMS NECESSARY IN ORDER TO
ADDRESS AREAS IN YOUR LIFE THAT MAY LEAD TO CRIMINAL BEHAVIOR.
15. IF YOU VIOLATE THE TERMS OF YOUR PROBATION/PAROLE/IP, ARE ARRESTED FOR A NEW OFFENSE OR ARE CONVICTED OF ANOTHER
OFFENSE WHILE UNDER COURT SUPERVISION your period of supervision may be revoked and you may be sentenced to a new period of
supervision, or a period of incarceration consistent with your recommended sentencing guidelines.
16. YOU MUST COMPLY WITH ANY COURT-IMPOSED SPECIAL CONDITIONS OF PROBATION/PAROLE/IP examples include no victim contact,
community service, drug & alcohol treatment. Failure to comply with your special conditions of probation/parole is a violation of the terms
of your probation.
17. IF YOU ARE SENTENCED TO A TERM OF INTERMEDIATE PUNISHMENT (INCLUDING ELECTRONIC MONITORING), you may be required to
undergo individual or family counseling; undergo available medical or psychiatric treatment or to enter and remain in a specified institution
for that purpose; be subject to intensive supervision while remaining within the jurisdiction of the court; to participate in drug or alcohol
screening and treatment programs, including inpatient programs; to do other things reasonably related to rehabilitation; or to be subject
to electronic monitoring.
By signing these general conditions and rules of probation/parole/IP, you acknowledge that you have read them or that they have been read to you,
that you understand them, that you have been given an opportunity to ask any questions you have about them and that you have been provided
with a copy of these general conditions and rules of probation/parole/IP.
Signature of Probationer/Parolee
Date