OFFICE OF THE STATE ATTORNEY, Larry Basford, 14TH JUDICIAL CIRCUIT OF FLORIDA 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Defendant’s Name and Date of Birth (D.O.B) at the top of the form.
3. Input the Case Number(s) if known. This helps in tracking your case efficiently.
4. List the Non-Profit Organization(s) where community service hours will be completed. Ensure to provide full names without abbreviations.
5. Fill in the Phone Number and Address of each organization, including area code, street, city, state, and zip code.
6. Document the Total Hours completed. Remember that you must complete either 8 or 28 hours at a non-profit organization.
7. Have your Supervisor(s) print their name and sign in the designated areas to certify completion of hours.
8. Finally, ensure that both the Defendant’s Signature and Date are filled out before submission.

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