Request for additional licence conditions form
First Name / xxx / Last Name / xxx / Date of Birth / xxx
B. CUSTODIAL INFORMATION
Sentence Type / DTO
Long-term Sentence / Releasing Establishment / xxx / Date of (proposed) release / xxx
Primary offence / xxx / Length of sentence / xxx / Date of Final Review / xxx
C. Additional Notice condition required (please provide exact wording) / Why is this additional Notice condition required to manage the Young person’s risk?
Please provide evidence why you feel that this additional condition is necessary to manage the young persons identified risk. This must evidence whether any less intrusive means of addressing the risk would be available and why these would not be appropriate for managing the young person’s risk.
/ What documented evidence supports the request for the additional licence condition?
e.g. please consider sentence planning, MAPPA meetings, case and risk management documents and assessments which are within date as considered by National Standards
1. / Example:
Not to enter the area of Royston as defined by the attached map without the prior approval of your supervising officer.
(Map must be attached which clearly outlines the excluded zone) / This exclusion zone has been requested to protect the victim and the local community.The victim has requested the condition via the Victim Liaison officer. The condition was discussed and agreed as per MAPPA meetings as it was agreed that given Nathan’s lack of remorse around his crime or empathy shown towards his victim as well as the close proximity of his home to where the offence was committed; no other option was available to manage Nathan’s risk.
We feel that this exclusion zone, whilst having a recognised impact on Nathan’s right to a private life, is not disproportionate. We are not seeking to exclude Nathan from any area other than the locality of the shop (where the offence was committed). The border of the exclusion zone is drawn to follow main roads to avoid the possibility of Nathan accidentally entering the zone. The zone as drawn does not exclude Nathan from visiting any family members or educational placements. / MAPPA minutes for meetings held on 7th July 2013 and 7th August 2013. Minutes can be obtained from the MAPPA administrator – Jenny Smith 01874 238754.
ROSH document – dated 3rrd September 2013 which identifies Nathan has being high risk of harm to others.
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N.b. Please tab down for more conditions, as required.
YOUTH OFFENDING TEAM DETAILSYOT / xxx / Sub Division / xxx / Supervising Officer (& Contact No) / xxx
Signature / xxx / Date form completed / xxx
Please send completed form either directly to the Youth Custody Service Placement Service (via
) or the secure placement (SCH or STC) alongside the final review paperwork.