Assigned Counsel Resource Center

Westchester County
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    Use tab to navigate through the menu items.

    Forms (Click on text to download document)

    ACRC

    • Request For Service

    • Video Request

    • ​Affidavit of Service

     

    Attorneys

    • Certificate Of Relief From Disabilities

    • Client Interview Form

    • General Case Closing Form (with instructions)

    • General Case Closing Form (fillable PDF)

    • HIPPA Form

    • Veterans Medical & Health Records Release

     
     

    DWI 

    • DWI/DWAI Conditions Of Probation

    • Ignition Interlock Financial Disclosure

    • DWI Pedigree Sheet For Registration (Vehicle)

    Judicial Diversion

    • Court Contract

    • Letter of Assignment to Client

    • Protocols

     

    Mental Health Court

    • Mental Health Court Contract

    • Program Guidelines

    • Release of Information Consent

     

    Probation

    • Conditions for Leandra's Law

    • DWI & Drug Conditions

    • Orders & Conditions of Adult Probation

    • Orders & Conditions of Interim Probation Supervision

    • Other Conditions for Sex Offenders

     

    SORA

    • Conditions of Probation

    • Hearing & Guidelines

    • Registerable Offenses

    • Risk Assessment Instrument

    • Risk Level Characteristics

     

    Waivers

    • Certificate Of Relief From Disabilities

    • Misdemeanor Conviction Waiver of Rights

    • Pedigree Sheet For County Court Pleas

    • SCI Waiver

     

    Assigned Counsel Resource Center
    150 Grand Street, Suite 100
    White Plains, NY 10601

    Office Phone#: (914) 286-3408 

    Fax#: (914) 328-4263

    For any general inquiries, please fill in this contact form.

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