Isle of Wight County Circuit Court, Virginia Document Filing Requirements

CRITICALCriminal cases

Applies to

Community service application

The application includes a supervisor’s approval identifying the agency and supervisor and confirming consent, supervision, and accurate reporting of hours to the Court.

SUPERVISOR’S APPROVAL On behalf of _____________________________ (agency name), I consent to the above work being performed, will supervise the work and will accurately report the hours worked to the Court. Date: ________________ _______________________________ Name & Title Phone: _______________ _______________________________ Signature

CRITICALCriminal cases

Applies to

Certification of community service performed

The certification identifies the person, case, supervisor, agency, and service dates; includes the supervisor’s sworn or affirmed statement of supervision and hours worked; and directs return to the Clerk at the stated address.

Name of person performing community service: __________________________________________________ Case Number(s): ___________________________________________________________________________ Name and title of person supervising community service: ___________________________________________ Name of agency where community service was performed:__________________________________________ Dates community service was performed: _______________________________________________________ Having supervised _______________________________ in the performance of their community service work described above, under the penalty of perjury, I swear or affirm that I supervised the work being performed and that ___________________ hours were worked by this Petitioner. Date: _________________ ________________________________ Supervisor's Signature Phone No. ___________________ Return Certification to: Laura E. Smith, Clerk Isle of Wight County Circuit Court P.O. Box 110 Isle of Wight, VA 23397

CRITICALCriminal cases

Applies to

Community service certification

The community-service certification requests the participant and case details, supervisor and agency information, service dates and hours, and the supervisor’s sworn statement, signature, date, and phone number.

Name of person performing community service: __________________________________________________ Case Number(s): ___________________________________________________________________________ Name and title of person supervising community service: ___________________________________________ Name of agency where community service was performed:__________________________________________ Dates community service was performed: _______________________________________________________ Having supervised _______________________________ in the performance of their community service work described above, under the penalty of perjury, I swear or affirm that I supervised the work being performed and that ___________________ hours were worked by this Petitioner. Date: _________________ ________________________________ Supervisor's Signature Phone No. ___________________

CRITICALCriminal cases

Applies to

Community service application

The community-service application requests the applicant’s identifying and case information, agency details, proposed work, community benefit, and a request for Court approval.

Name: ______________________________________ Date: _______________________________ Address: _________________________________________________________________________________ Case Number(s): ___________________________________________________________________________ Name of agency where community service will be performed:________________________________________ Address of agency: _________________________________________________________________________ Type of work you will be performing: __________________________________________________________ How the work will benefit the community: ______________________________________________________ I hereby request the Court’s approval to perform community service as set forth above.

WARNINGCriminal cases

Applies to

Community service certification

Return the certification to the Clerk of the Isle of Wight County Circuit Court at the listed address.

Return Certification to: Laura E. Smith, Clerk Isle of Wight County Circuit Court P.O. Box 110 Isle of Wight, VA 23397