Form IX

[See Rule 32(1)(e)]

Chronological Register of Probationer

SerialNo.

Name of Probationer, father's name and address

Sex, age, religion, and identification marks etc.

Offence (give section and brief description of the offence)

Court passing the supervision order and Case No.

Date of supervision order and period of supervision

Name of the Probation Officer

Pre-sentence report submitted or not (if submitted, give

P.R., No. and date)

Whether the Probationer is residing in institution and

premises for the reception of probationers, if so, give the

name and address of the home.

Name and address of sureties, if any

1

2

3

4

5

6

7

8

9

10

Occupation, if any, and wages, name and address of

employer, if any

Any variation in original supervision order and the date of

such variation

No. of visits paid

No. of visits received

No. of progress reports submitted

Result of probation and remarks of Probation Officer, if any

Subsequent history after completion of probation

17

First year

Second year

Third year

Fourth year

Fifth year

11

12

13

14

15

16

(a)

(b)

(c)

(d)

(e)