Free Probation Form 12B - District Court of Connecticut - Connecticut

Case 3:03-cr-00240-SRU Document 18-2 Filed 01/18/2007 Page 1 of 1
PROB 49
(3/89)
Mnitzb §tatzs Zbtstrntt Qluurt
District of Connecticut
Waiver of Hearing to Modify Conditions of Probation/Supervised Release or Extend Term of
Supervision
I have been advised and understand that I am entitled by law to a hearing and assistance of counsel before
any unfavorable change may be made in my Conditions of Probation and Supervised Release or my period of
supervision being extended. By "assistance of counsel," I understand that I have the right to be represented
at the hearing by counsel of my own choosing if I am able to retain counsel. I also understand that I have the
right to request the court to appoint counsel to represent me at such a hearing at no cost to myself if I am not
able to retain counsel of my own choosing.
I hereby voluntarily waive my statutory right to a hearing and to assistance of counsel. I also agree to
the following modification of my Conditions of Probation and Supervised Release orto the proposed extension
of my term of supervision:
The term of probation is extended for 60 days for the purpose of complying with DNA collection.
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