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The Florida Monthly Report form is a crucial document for individuals under supervision by the Department of Corrections. This form requires detailed personal information, including the officer's name, the reporting individual's DC number, and their residence address. It also collects employment details, such as the employer's name and contact information, alongside the total monthly earnings. Individuals must disclose any interactions with law enforcement, substance use, and participation in educational or self-improvement programs. Furthermore, the form asks for information about household members and any financial obligations owed to the Department. It emphasizes the importance of accuracy and completeness, as a signature certifying the truthfulness of the information is required. This report must be submitted on time to ensure compliance with probation or parole conditions, making it essential for maintaining a positive relationship with supervising officers.
Form Example
STATE OF FLORIDA
DEPARTMENT OF CORRECTIONS
WRITTEN MONTHLY REPORT
Officer’s Name: ______________
For Month Ending: ___________
Date/Time submitted:__________
YOUR NAME: ___________________________________
DC#: _______________
YOUR RESIDENCE ADDRESS: (include Name of Subdivision, Apartment Complex and Number, Mobile Home Park and Lot Number, if applicable):
__________________________________________________
__________________________________________________
__________________________________________________
(Provide physical location – NOT Post Office Box)
TELEPHONE No. __________________________________
CELLULAR TELEPHONE No.______________________
PAGER No. ______________________________________
VehicleMake/Model/Year/Tagg#: #:
_______________________________________________
EMPLOYER: _____________________________________
SUPERVISOR’S NAME: ___________________________
EMPLOYER’S ADDRESS:
__________________________________________________
__________________________________________________
EMPLOYER’S TELEPHONE No. ____________________
CELLULAR TELEPHONE No.______________________
PAGER No. ______________________________________
EMPLOYER EMAIL: ______________________________
YOUR TOTAL MONEY EARNED MONTHLY: $__________________ (Gross Amount)
Full time____
Additional (2nd) employment information: ______________
List full names, ages, and your relationship to all persons who resided at your residence during this month:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
YES NO Have you consumed alcoholic beverages? 
Have you used or bought illegal drugs or controlled substances? 
Have you attended educational, vocational classes or mental
health, drug, alcohol, therapy, or
Have you been arrested or had any contact with law enforcement during the last month? If yes, explain what happened on separate sheet of paper, attached to report.
If you went into debt for any reason, explain: ____________________________________________________________________
If not working, give reason and source of income: ________________________________________________________________
If you have any questions or problems to discuss with your Officer, explain:___________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
If monetary obligation owed, amount paid this month: |
$________________ |
Receipts are available through your probation officer. DO NOT SUBMIT CASH OR PERSONAL CHECKS!
Make money order payable to the Department of Corrections.
If monetary obligation owed and no payment made, give reason and date when payment will be made: ____________________
__________________________________________________________________________________________
Official Use Only:
Signature of Officer Receiving Report:
__________________________________________________
Date WMR Received: _____________
Date WMR Due: _________________
Comments:
I certify the above to be true and complete:
Your Signature:
Mailing Address:
City:
State:___________ Zip:
Document Breakdown
| Fact Name | Description |
|---|---|
| Purpose | The Florida Monthly Report form is used by individuals on probation to report their monthly activities and financial status to their supervising officer. |
| Governing Law | This form is governed by Florida Statutes, Chapter 948, which outlines the conditions of probation and reporting requirements. |
| Submission Timeline | The report must be submitted by the end of each month, as indicated by the "For Month Ending" section. |
| Personal Information | Individuals must provide their name, DC number, and physical address, ensuring no use of P.O. Boxes. |
| Employment Details | Report includes sections for employer information, job title, and total earnings for the month. |
| Substance Use Disclosure | The form requires disclosure of any alcohol or drug use during the reporting period. |
| Debt Explanation | If the individual incurred debt, they must provide an explanation on the form. |
| Payment Instructions | Individuals must not submit cash or personal checks. Payments should be made via money order to the Department of Corrections. |
| Certification | Individuals must certify the accuracy of the information provided by signing the report before submission. |
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