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COMMUNITY SERVICE WORKSHEET THIRD DISTRICT JUVENILE COURT 450 S STATE STREET - 2ND FLOOR PO BOX 140431 SALT LAKE CITY UT 84114-0431 NAME ADDRESS NJ CT CASE NUMBER DATE OF BIRTH ORDER TO BE COMPLETED AMOUNT DUE DATE AGE COMPLETED RESTITUTION DATE DESCRIPTION OF WORK SIGNATURES WORKER ACKNOWLEDGMENT LOCATION JUVENILE SUPERVISOR OF HOURS FOR JUVENILE AND FAMILIES Your youth has been ordered by the Court to work Community Service hours and it is your child s responsibility to complete this assignment. As the parent s /guardian s it is your responsibility to assess your youth in complying with this Court order by providing 1 support 2 supervision 3 transportation and 4 keeping accurate records of dates and hours the youth has worked* This assignment must be approved by the Court before beginning the work or program* Documentation of hours worked must be received by the Court in order to verify that the assignment has been completed* Verification is also needed for program credit. Some suggestions for your Community Service jobs and programs in your neighborhood are 1. Schools 3. Neighbors or family member 65 or older or disabled*. yard work/gardening/errands 5. Churches Charitable/non-profit agencies Substance Abuse Program Litter pick-up Others MUST be approved by the Court ADHERENCE TO THE FOLLOWING IS IMPORTANT 1. The work must NOT BE HAZARDOUS* 2. Neither the youth nor the parent/guardian are to receive any money or compensation for any service performed* 3. Most government federal state county and city agencies or animal shelters are not available for this assignment. 4. Business/commercial enterprises are NOT approved or this assignment. Please mail all documentation and refer any questions to 450 SOUTH STATE. As the parent s /guardian s it is your responsibility to assess your youth in complying with this Court order by providing 1 support 2 supervision 3 transportation and 4 keeping accurate records of dates and hours the youth has worked* This assignment must be approved by the Court before beginning the work or program* Documentation of hours worked must be received by the Court in order to verify that the assignment has been completed* Verification is also needed for program credit. Some suggestions for your Community Service jobs and programs in your neighborhood are 1. Schools 3. Some suggestions for your Community Service jobs and programs in your neighborhood are 1. Schools 3. Neighbors or family member 65 or older or disabled*. yard work/gardening/errands 5. Churches Charitable/non-profit agencies Substance Abuse Program Litter pick-up Others MUST be approved by the Court ADHERENCE TO THE FOLLOWING IS IMPORTANT 1. Neighbors or family member 65 or older or disabled*. yard work/gardening/errands 5. Churches Charitable/non-profit agencies Substance Abuse Program Litter pick-up Others MUST be approved by the Court ADHERENCE TO THE FOLLOWING IS IMPORTANT 1. The work must NOT BE HAZARDOUS* 2. Neither the youth nor the parent/guardian are to receive any money or compensation for any service performed* 3.

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Keywords relevant to Community Service Worksheet Form

  • adherence
  • complying
  • acknowledgment
  • restitution
  • ut
  • verification
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  • Guidelines
  • HAZARDOUS
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