V Furlough order  


FORM V
FURLOUGH ORDER
STATE OF NEW YORK
 
□ SUPREME COURT □ COUNTY COURT
 
PART:
__
COUNTY:
 
__________
IN THE MATTER of A Furlough Order Pursuant to CPL 330.20 in Relation to
__________
Defendant
__________
Present:
 
Honorable
 
□ Justice of the Supreme Court
 
□ Judge of the County Court
 
The above-named defendant having been found not responsible by reason of mental disease or defect and now being in the custody of the State Commissioner of Mental Health and confined in a facility for care and treatment pursuant to [check one of the following]
□ a commitment order issued under the provisions of subdivision 6 of CPL 330.20
□ a recommitment order issued under the provisions of subdivision 14 of CPL 330.20
□ a first retention order issued under the provisions of subdivision 8 of CPL 330.20
□ a second retention order issued under the provisions of subdivision 9 of CPL 330.20
□ a subsequent retention order issued under the provisions of subdivision 9 of CPL 330.20
by the following court on the following date:
[Name of court]
 
[Date of order]
 
□ And, an application having been made pursuant to subdivision 10 of CPL 330.20 by the State Commissioner of Mental Health for a furlough order;
□ And, a demand for a hearing not having been made;
□ And, a demand for a hearing having been made by the District Attorney, and such hearing having been held on
 
;
□ And, the court, on its own motion, having conducted a hearing on
 
 
;
And, due deliberation thereon having been had,
And, the court having found that the issuance of a furlough order is consistent with the public safety and welfare of the community and the above-named defendant, and that the clinical condition of the above-named defendant warrants a granting of the privileges authorized by a furlough order,
It is hereby
ORDERED that the Commissioner of Mental Health is directed to allow the above-named defendant, now in confinement in a facility pursuant to the aforesaid order, to temporarily leave the facility for [here insert a period of time not exceeding 14 days] __ under the following terms and conditions:
□ (a) While outside the facility pursuant to this order, the above-named defendant shall be under the constant supervision of □ one employee □ two employees □ three employees of the facility;
□ (b) While outside the facility pursuant to this order, the above-named defendant need not be under the constant supervision of any employee of the facility;
□ (c) [Here insert any terms and conditions that the court deems necessary or appropriate]
 
 
Dated: _________
 
□ Justice of the Supreme Court
 
□ Judge of the County Court