Forms

Order for GPS Monitoring

ELECTRONIC MONITORING CONTRACT

Tampa Monitoring Solutions 813-777-5137

NAME

CASE NUMBER

Initial the following statements confirming the device you have been issued and acknowledging your understanding of the monitoring instructions, requirements, and care of the assigned device.

The following device has been issued to me:

The following device has been issued to me: Content

Checkbox

I am to remain at my residence or designated locations according to the approved electronic monitoring schedule provided to me. I must adhere to all designated curfew hours.

Failure to make payments on time will result in violation of my monitoring conditions and will be reported immediately to Judge, Jail, or Probation officer.

I am responsible for the device assigned to me and will not tamper with or remove the device.

I am responsible for keeping this device charged at all times and maintaining the Global Positioning System (GPS) signal.

I am responsible for paying for any intentional damage or loss of this device. I also understand I may be charged with a new crime under these circumstances.

I must contact TAMPA MONITORING SOLUTIONS if I have any violations or issues with the GPS device.

I have reviewed this form with TAMPA MONITORING SOLUTIONS. I fully understand the instructions regarding the use of the monitor assigned to me and acknowledge that I am responsible for safeguarding the device.

Signature

Date

TAMPA MONITORING ( Agent )

Date

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Order for GPS Monitoring

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ELECTRONIC MONITORING CONTRACT

Tampa Monitoring Solutions 813-777-5137