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  • MOHAVE COUNTY ADULT PROBATION DEPARTMENT

    MOHAVE COUNTY ADULT PROBATION DEPARTMENT

  • PRE-SENTENCE INVESTIGATION QUESTIONNAIRE

  • PURPOSE OF THE PRE-SENTENCE INVESTIGATION REPORT (PSI):

  • To provide the Judge with sufficient information about a crime and your involvement in it so he can decide your appropriate sentencing. It will contain a summary of your offense; any statement(s) you make about it; your social history; and statement(s) provided by any victims, law enforcement officers, or anyone else involved with you or your case. It will also include your prior criminal and traffic records as well as any outstanding warrants found. You are NOT "on probation" just because you are completing this questionnaire. You are participating in the pre-sentence investigation process, which occurs in nearly all felony cases regardless of the possible sentence.
  • Your PSI will be prepared by a Deputy Probation Officer; a professional who has the education, training, and experience to understand and evaluate human behavior and criminal justice issues. The PSI writer is NOT an attorney: he/she represents the Court-NOT you or your attorney, nor the prosecuting attorney or the police. If your plea or conviction allows for at least the possibility of probation, the PSI writer will give the Judge an evaluation of your ability to successfully complete such a term. You may not agree with the PSI writer's opinions; however, he/she will make every effort to prepare as accurate, complete, and objective a report as possible in your case. Your attorney will review yours with you to determine whether any corrections or additions need to be given to the Judge in court.

  • Instructions for returning this questionnaire:

  • 1) IF YOU ARE NOW IN JAIL: Complete the attached questionnaire and give it to a Detention Officer to be forwarded to the Probation Department. Your PSI officer may contact you through the jail telephone afterward to interview you. If you are released from jail before completing this questionnaire, see the paragraph below.
  • 2) IF YOU ARE NOT IN JAIL: Complete the attached questionnaire and return it IN-PERSON to the probation office nearest to where you live (see locations at the bottom of this page). If you live outside of Mohave County, you may return this questionnaire by E-MAIL to the assigned officer or by FAX to the Kingman probation office.
  • 3) BY MAIL: Send the questionnaire to Mohave County Probation, P.O. Box 7000, Kingman, AZ 86402-7000. You will be responsible for the cost of mailing. Be sure to consider the time needed for the postal service to deliver it. Use the above address; do not send any mail to the three office addresses at the bottom of this page.
  • Your PSI officer may contact you to review or clarify information you provide once he/she receives your questionnaire. If your attorney tells you not to answer any part of the questionnaire, let the PSI writer know that is why you did not fill out that portion. The final ruling has yet to occur in your case; failure by you to cooperate with the probation department in this investigation may weigh against you when the Judge decides your sentence.
  • Statements or documents on your behalf may be given to your attorney who can then provide them to the Judge.
  • Statements or documents on your behalf may be given to your attorney who can then provide them to the Judge.
    Kingman (main office) Bullhead City Lake Havasu City
    Mohave County Probation Dept. 809 E. Beale Street Kingman, AZ 86402-7000 Mohave County Probation Dept. 967 Hancock Road, Suite 25 Bullhead City, AZ 86442 Mohave County Probation Dept. 2001 College Drive, Suite 129 Lake Havasu City, AZ 86404
    Phone: 928-753-0741 Fax: 928-718-5508 Phone: 928-758-0738 Fax: 928-763-8744 Phone: 928-453-0707 Fax: 928-855-1969
  • ** DO NOT MAIL YOUR QUESTIONNAIRE TO THESE OFFICES - SEE ABOVE "RETURNING BY MAIL" **
  • STAY IN CONTACT WITH YOUR ATTORNEY for any changes to your sentencing date.

  • I. PERSONAL INFORMATION

  •  - -
  • SEX:*
  • RACE:*
  • DO YOU HAVE A SEPARATE MAILING ADDRESS?*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • II. PHYSICAL HEALTH

  • ARE YOU IN OVERALL GOOD HEALTH WITH NO SIGNIFICANT MEDICAL PROBLEMS.*

  • III. MENTAL HEALTH

  • DO YOU HAVE ANY HISTORY OF MENTAL/EMOTIONAL HEALTH PROBLEMS.*
  • ARE YOU CURRENTLY TAKING ANY MEDICATIONS?*

  • IV. RESIDENCE / NEIGHBORHOOD

  • HOW MANY TIMES HAVE YOU MOVED OVER THE PAST 6 MONTHS?*
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  • DO YOU PLAN TO MOVE IN THE NEXT 90 DAYS?*
  • DO YOU - OR ANYONE WITH WHOM YOU PLAN TO LIVE - POSSESS OR HAVE ACCESS TO ANY FIREARMS, DEADLY WEAPONS, MARTIAL ARTS WEAPONS, EXPLOSIVES, OR TOXIC SUBSTANCES?*
  • ARE THERE ANY DANGEROUS OR EXOTIC ANIMALS / PETS AT YOUR RESIDENCE?*

  • V. EMPLOYMENT / VOCATIONAL

  • ARE YOU EMPLOYED NOW?*
  • TYPE OF WORK?
  • OVER THE PAST 3 YEARS, HOW MANY TIMES HAVE YOU BEEN UNEMPLOYED FOR A PERIOD OF 30 DAYS OR MORE?*
  • OVER THE PAST 3 YEARS, HAVE YOU BEEN FIRED OR ASKED TO RESIGN FROM A JOB?*
  • DO YOU HAVE A SECOND JOB OR ARE SELF EMPLOYED?*
  • DOES ANYONE ELSE HELP SUPPORT YOU FINANCIALLY?*

  • VI. FINANCIAL

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  • DO YOU RECEIVE FOOD STAMPS?
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  • HAVE YOU EVER FILED FOR BANKRUPTCY?

  • VII. EDUCATION

  • DID YOU GRADUATE HIGH SCHOOL?*
  • DID YOU EARN A GED?
  • WERE YOU EVER SUSPENDED OR EXPELLED FROM SCHOOL?*
  • DID YOU ATTEND COLLEGE?*
  • DID YOU EARN A DEGREE?
  • IF "YES":
  • HAVE YOU EVER ATTENDED VOCATIONAL TRAINING?

  • VIII. MILITARY SERVICE:

  • HAVE YOU SERVED IN THE UNITED STATES ARMED FORCES?*
  • WHICH BRANCH:
  • COMBAT SERVICE?
  • ARE YOU NOW RECEIVING ANY SERVICES THROUGH VETERAN'S AFFAIRS?

  • IX. FAMILY HISTORY:

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  • WERE YOU ADOPTED?*
  • WERE YOU RAISED BY YOUR BIRTH PARENTS?*
  • WHAT AGE DID YOU LEAVE THE FAMILY HOME?*
  • DO ANY OF YOUR PARENTS OR SIBLINGS HAVE A CRIMINAL RECORD (NOT TRAFFIC)?*
  • OVERALL, HOW WOULD YOU DESCRIBE YOUR PRESENT RELATIONSHIP WITH YOUR FAMILY?*
  • WAS YOUR CHILDHOOD:*
  • DID YOU EVER WITNESS DOMESTIC VIOLENCE AS A CHILD?*
  • WERE YOU EVER ABUSED AS A CHILD?*
  • IF "YES", HOW SO:
  • DID THE ABUSE RESULT IN:

  • X. SOCIAL / PEERS

  • DO YOU CURRENTLY HAVE AT LEAST ONE NON-FAMILY MEMBER YOU MAINTAIN A FRIENDSHIP WITH WHO YOU COULD RELY ON FOR HELP IF NEEDED?*
  • IS THAT PERSON A GOOD INFLUENCE?

  • XI. MARRIAGE / RELATIONSHIP / CHILDREN

  • YOUR CURRENT STATUS:*
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  • HAVE YOU EVER HAD ANY DCS / CHILD PROTECTIVE SERVICES INVOLVEMENT?*

  • XII. SUBSTANCE ABUSE - HISTORY (TCU 5)

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  • Which drug caused the most serious problem during the last 12 months? [CHOOSE ONE]
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  • How many times before now have you ever been in a drug treatment program? [DO NOT INCLUDE AA/NA/CA MEETINGS]
  • 15. How serious do you think your drug problems are?
  • 16. During the last 12 months, how often did you inject drugs with a needle?
  • 17. How important is it for you to get drug treatment now?

  • XIII. SUBSTANCE ABUSE - TREATMENT

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  • ARE YOU NOW ATTENDING ANY TREATMENT OR COUNSELING?
  • HAVE YOU EVER PARTICIPATED IN A DRUG COURT PROGRAM BEFORE?
  • DO YOU THINK YOU NEED TREATMENT OR COUNSELING NOW FOR ANY REASON?

  • XIV. CRIMINAL RECORD

  • AS AN ADULT, HOW MANY TIMES HAVE YOU BEEN:

  • ARE YOU CURRENTLY WANTED IN ANY JURISDICTION?
  • DO YOU HAVE ANY PROTECTIVE OR RESTRAINING ORDERS AGAINST YOU?
  • DO YOU HAVE ANY OTHER PENDING CASES BESIDES THIS ONE?
  • HAVE YOU EVER BEEN REQUIRED TO REGISTER AS A:
  • ARE YOU REGISTERED AS A SEX OFFENDER IN MOHAVE COUNTY NOW?

  • XV. OTHER INFORMATION

  • HAVE YOU EVER ASSOCIATED WITH A GANG?*
  • DO YOU STILL ASSOCIATE WITH ANY GANG MEMBERS?
  • HAVE YOU EVER BEEN OR ARE YOU CURRENTLY BEING FORCED OR TRICKED INTO EXCHANGING SEX FOR SOMETHING OF VALUE LIKE A PLACE TO STAY, PROTECTION, DRUGS, CLOTHING, OR FOOD?*
  • HAVE YOU EVER BEEN, OR ARE YOU CURRENTLY BEING FORCED OR TRICKED INTO EXCHANGING SEX FOR MONEY?*
  • HAVE YOU EVER BEEN OR ARE YOU CURRENTLY INVOLVED IN PROSTITUTION?*
  • IF BEING SENTENCED ON A PLEA AGREEMENT, DO YOU PLAN TO ASK THE JUDGE TO WITHDRAW YOUR PLEA FOR ANY REASON?*

  • XVI. YOUR VIEWPOINT

  • YOUR OPINION

  • XVIII. DEFENDANT'S STATEMENT

  • IN ORDER TO GIVE THE JUDGE A CLEAR PICTURE OF WHY YOU ARE IN COURT NOW AND WHAT SENTENCE YOU SHOULD RECEIVE, IT IS IMPORTANT YOU TELL YOUR SIDE OF THE STORY: WHAT WAS YOUR INVOLVEMENT IN THE CRIME(S), ANY ERRORS MADE IN THE POLICE REPORTS, WHAT THE JUDGE MIGHT EXPECT YOUR BEHAVIOR TO BE AFTER SENTENCING, ETC.
  • WRITE YOUR STATEMENT HERE.
  • DID ANYONE ELSE HELP YOU FILL OUT THIS QUESTIONNAIRE?*
  •  - -

  • IMPORTANT THINGS TO CONSIDER

  • WHILE ON PROBATION, YOU WILL BE SUBJECT TO THE FOLLOWING:

  • DRUG TESTING - THIS IS A STANDARD TERM OF PROBATION. THE FREQUENCY OF DRUG TESTING IS UP TO YOUR PROBATION OFFICER. YOU WILL BE RESPONSIBLE FOR THE COST OF THE DRUG TESTING, TYPICALLY BETWEEN $5 TO $15 PER TEST.

  • ALCOHOL RESTRICTIONS - IF THE JUDGE ORDERS NO ALCOHOL, YOU WILL NOT BE PERMITTED TO CONSUME ALCOHOL. FURTHER, YOU MAY NOT HAVE ANY ALCOHOL IN YOUR RESIDENCE. ANY ALCOHOL FOUND WILL BE CONSIDERED YOURS AND YOU MAY BE SUBJECT TO A PROBATION VIOLATION.
  • TREATMENT - THE JUDGE OR YOUR PROBATION OFFICER MAY DIRECT YOU TO PARTICIPATE IN A TREATMENT PROGRAM. THIS WILL BE AT YOUR OWN EXPENSE, ALTHOUGH HEALTH INSURANCE (INCLUDING AHCCCS) CAN REDUCE THE COST SIGNIFICANTLY.
  • CONTACT RESTRICTIONS - YOU WILL NOT BE ALLOWED TO ASSOCIATE WITH ANYONE WITH A CRIMINAL RECORD (I.E. CONVICTED FELONS, OTHERS ON PROBATION/PAROLE, CO-DEFENDANTS) WITHOUT YOUR PROBATION OFFICER'S APPROVAL. THIS MAY INCLUDE FAMILY MEMBERS. YOUR PROBATION OFFICER WILL DETERMINE IF CONTACT WILL BE ALLOWED OR NOT.
  • WEAPONS RESTRICTIONS - WHILE ON PROBATION YOU ARE PROHIBITED FROM POSSESSING FIREARMS, DEADLY WEAPONS, AMMUNITION, STUN GUNS, AND TASERS. EVEN IF THEY DO NOT BELONG TO YOU, THESE ITEMS MAY NOT BE AT YOUR RESIDENCE OR ANYWHERE THAT YOU HAVE ACCESS TO THEM. YOUR PROBATION OFFICER WILL DECIDE IF WEAPONS NOT BELONGING TO YOU CAN REMAIN THERE IF PROPERLY SECURED.
  • RESIDENCE CHANGES - YOU MAY ONLY CHANGE YOUR ADDRESS WITH YOUR PROBATION OFFICER'S PERMISSION AHEAD OF TIME. IF YOU MOVE AND DO NOT TELL YOUR PROBATION OFFICER, IT IS LIKELY A WARRANT WILL BE ISSUED FOR YOUR ARREST AND YOUR PROBATION MAY BE REVOKED.
  • TRANSPORTATION - YOU ARE RESPONSIBLE FOR TRANSPORTATION TO OFFICE MEETINGS WITH YOUR PROBATION OFFICER, AS WELL AS TO TREATMENT, DRUG TESTING, COMMUNITY SERVICE, COURT DATES, ETC.
  • SEARCH AND SEIZURE - WHILE ON PROBATION YOU WILL NOT BE AFFORDED FULL PROTECTION UNDER THE 4TH AMENDMENT TO THE U.S. CONSTITUTION. PROBATION OFFICERS HAVE THE RIGHT TO SEARCH AND SEIZURE WITHOUT A SEARCH WARRANT. THIS MEANS PROBATION OFFICERS CAN ENTER YOUR RESIDENCE AT ANY TIME EVEN IF YOU ARE NOT AT HOME. PROBATION OFFICERS HAVE AUTHORITY UNDER STATE LAW TO DETAIN EVERYONE IN YOUR HOME FOR THEIR SAFETY WHILE AT YOUR RESIDENCE. EVEN IF YOU DO NOT PERSONALLY OWN THE RESIDENCE WHERE YOU LIVE, IF YOU ARE THERE, IT IS CONSIDERED TO BE YOUR RESIDENCE. ESSENTIALLY, ANYTHING THAT YOU HAVE ACCESS TO, YOUR PROBATION OFFICER HAS ACCESS TO.
  • REMINDER: YOU MUST REPORT TO THE PROBATION OFFICER AT THE COURTHOUSE OR AT THE KINGMAN OFFICE OF THE PROBATION DEPARTMENT IMMEDIATELY FOLLOWING SENTENCING OR RELEASE.

  • LIVING IN ANOTHER ARIZONA COUNTY:

  • IF YOU PLAN ON LIVING IN A COUNTY OTHER THAN MOHAVE, YOU WILL BE SUBJECT TO WHAT IS CALLED "COURTESY SUPERVISION". PRIOR TO LEAVING MOHAVE COUNTY, YOU MUST MEET WITH YOUR PROBATION OFFICER, COMPLETE A COURTESY SUPERVISION APPLICATION, AND PAY A $150.00 APPLICATION FEE. THE OTHER COUNTY MAY WISH TO INVESTIGATE WHERE YOU PLAN TO LIVE, WORK, ETC PRIOR TO ACCEPTING YOU. IN SUCH CASES, YOU WILL BE REQUIRED TO REMAIN IN MOHAVE COUNTY UNTIL ACCEPTANCE IS RECEIVED.

  • IF YOU ARE A RESIDENT OF THAT COUNTY AT SENTENCING (MEANING YOU HAVE LIVED THERE AT LEAST 180 DAYS AND CAN SHOW PROOF), YOU WILL BE PERMITTED TO RETURN HOME THE DAY OF SENTENCING, BUT YOU MUST STILL MEET WITH A PROBATION OFFICER HERE, COMPLETE THE APPLICATION, AND PAY THE APPLICATION FEE BEFORE LEAVING. THIS CAN USUALLY BE ACCOMPLISHED BY MEETING WITH THE PROBATION OFFICER AT THE SUPERIOR COURTHOUSE, OR YOU MAY REPORT TO THE KINGMAN OFFICE OF THE PROBATION DEPARTMENT AT 809 E. BEALE STREET.

  • LIVING IN ANOTHER STATE WHILE ON PROBATION:

  • **IF YOU PLAN ON LIVING IN ANOTHER STATE BESIDES ARIZONA AFTER BEING PLACED ON PROBATION, PLEASE READ BELOW **
  • REQUIRED INTERSTATE COMPACT APPLICATION AND EXTRADITION BOND FEES
  • Image field 299
  • Alaska/Hawaii and all US Territories will be assessed at $3000

  • ALL PROBATIONERS PLANNING TO RESIDE IN ANOTHER STATE SHALL PAY THE
    $300.00 APPLICATION FEE AND THE FULL AMOUNT OF THE EXTRADITION BOND
    (SEE MAP) PRIOR TO REQUESTING TO TRANSFER SUPERVISION UNDER THE
    INTERSTATE COMPACT FOR ADULT OFFENDER SUPERVISION.

  • YOU MUST SEE THE PROBATION OFFICER IN THE COURTHOUSE FOLLOWING
    SENTENCING IF YOU PLAN TO LIVE IN ANOTHER STATE – PLAN TO STAY IN
    ARIZONA AT LEAST ONE DAY, IN CASE THE PROBATION OFFICER IN THE
    COURTHOUSE CANNOT MEET WITH YOU IMMEDIATELY.
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