BROOMFIELD MUNICIPAL COURT

17 DESCOMBES DRIVE, BROOMFIELD, CO 80020

Telephone: 720-887-2100  

COMMUNITY SERVICE TIME SHEET

ALL COMMUNITY SERVICE HOURS MUST BE PERFORMED AT AN

IRC SECTION 501 (c) (3) NON-PROFIT AGENCY

 

Defendant:___________________________________Case #:____________________

 

Number of hours court ordered:_______Due date for completion:_______________

 

DATE             TIME IN/TIMEOUT             SUPERVISOR          DUTIES

________        __________________            _____________          ________________________

________        __________________            _____________          ________________________

________        __________________            _____________          ________________________

________        __________________            _____________          ________________________

________        __________________            _____________          ________________________

________        __________________            _____________          ________________________

________        __________________            _____________          ________________________

________        __________________            _____________          ________________________

 

TOTAL HOURS COMPLETED__________________

 

PLEASE COMPLETE AND CHECK ALL BOXES:

        NON-PROFIT AGENCY NAME:__________________________________________

        NON-PROFIT EMPLOYEE/SUPERVISOR’S SIGNATURE:

__________________________________________________________________________

        PRINT NAME:__________________________________________________________      

        NON-PROFIT TELEPHONE NUMBER:____________________________________

(CELL PHONE NUMBERS WILL NOT BE ACCEPTED)

        BY SIGNING THE SUPERVISOR VERIFIES HE/SHE IS AN EMPLOYEE OF THE NON-PROFIT AND SUPERVISED THE COMPLETION OF WORK. 

 

PLEASE RATE DEFENDANT’S WORK PERFORMANCE:

 

ATTITUDE                            Poor                Fair                 Good               Excellent

WILLINGNESS                    Poor                Fair                 Good               Excellent

WORK PRODUCTIVITY    Poor                Fair                 Good               Excellent

ADDITIONAL COMMENTS:___________________________________________________

 

 

ALL COMMUNITY SERVICE IS SUBJECT TO VERIFICATION BY THE COURT IN ORDER TO BE ACCEPTED BY THE COURT.

 

 

THE DEFENDANT IS REQUIRED TO RETURN THIS VERIFIED SHEET TO THE BROOMFIELD MUNICIPAL COURT BY THE ASSIGNED DUE DATE, FAILURE TO DO SO OR FAILURE TO COMPLY WITH VERIFICATION MAY RESULT IN THE ISSUANCE OF A WARRANT FOR THE DEFENDANT’S ARREST

 

ANY MISREPRESENTATION OF COMMUNITY SERVICE NOT ACTUALLY COMPLETED MAY ALSO RESULT IN ADDITIONAL CONTEMPT PROCEEDINGS AGAINST THE DEFENDANT