Form CJ-17 Census of Juveniles on Probation

National Juvenile Probation Census Project

CJPcj17lfillable

National Juvenile Probation Census Project

OMB: 1121-0291

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1121-0291 can be found here:

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U.S. DEPARTMENT OF COMMERCE

OFFICE OF JUVENILE JUSTICE AND DELINQUENCY PREVENTION

CENSUS OF JUVENILES ON PROBATION

Economics and Statistics Administration
U.S. CENSUS BUREAU
ACTING AS COLLECTING AGENT FOR
Office of Juvenile Justice and Delinquency Prevention

U.S. DEPARTMENT OF JUSTICE

BOX A

PLEASE COMPLETE QUESTIONNAIRE FOR
BOX B

Please complete the questionnaire before November 29, 2006 by accessing the EXCEL
document on the web information page at http://harvester.census.gov/cjp, by
mailing the completed questionnaire to the U.S. Census Bureau in the enclosed
envelope, or faxing all pages toll-free to 1–888–891–2099.

If you have questions about completing the form,
please call Theresa Reitz
toll-free at 1–800–352–7229 or e-mail [email protected].
Name

Title

Mailing address – Number and street/or P.O. Box/Route number

City

E-mail address

Telephone number
Area code Number

FORM

CJ-17L

State

Fax number
Extension

Area code Number

OMB No. 1121-0291: Approval Expires 12/31/2007

(9-12-2006)

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ZIP Code

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Section I – SUMMARY OF JUVENILE PROBATION COUNTS
IMPORTANT INSTRUCTIONS

Please complete this questionnaire for the juvenile probation supervision office identified in
BOX B on the front page.
For the remainder of this questionnaire, the phrase "this office" refers to the juvenile
probation supervision office identified in BOX B on the front cover page.
1a. Does this office provide OR oversee the provision of FORMAL court ordered juvenile probation
supervision?
Yes
No ➔ STOP HERE and mail this form

1b. According to your records, on Wednesday, October 25, 2006, how many juveniles were on
FORMAL court ordered juvenile probation supervision through this office and any probation
office(s) that this office oversees? Please note instructions carefully.
DO NOT include in your count juveniles who were, on Wednesday, October 25, 2006:
• on PAROLE
• on INFORMAL non-court ordered probation
• in a RESIDENTIAL FACILITY even if those juveniles were on court ordered probation
(data are collected on this population in a separate census).
INCLUDE in your count juveniles who were, on
Wednesday, October 25, 2006, on AFTERCARE.

Total count of

juveniles on FORMAL court ordered probation

2a. Does this office provide OR oversee the provision of INFORMAL non-court ordered juvenile
probation supervision?
Yes
No – SKIP TO QUESTION 3

2b. On Wednesday, October 25, 2006, how many juveniles were on INFORMAL non-court ordered
probation supervision through this office?
Total count of

juveniles on INFORMAL probation

What best describes the geographic area served by this office and any offices that this office
oversees? Please mark (X) only ONE geographic area and provide the name(s) of the area served.
Area type

A single municipality

Name(s) of area(s)

(Name of municipality)

➔

Multiple municipalities (Name of municipalities)

➔

A single county

(Name of county)

Multiple counties

(Name of counties)

Other type of area

(Name of area)

➔
➔

➔

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Section II – PERSON LEVEL DATA

1. This section collects information for each juvenile on formal court
ordered juvenile probation supervision through this office on
October 25, 2006.
2. The following methods of reporting are available to you:
Method

What it does

Excel Spreadsheet

Provides an electronic EXCEL
spreadsheet with the same fields
appearing on Section II. Information for
each juvenile may be directly typed into
the spreadsheet.

CJ-17L Questionnaire

A paper copy for manual data
submission.

If you choose not to utilize any of the above reporting methods, we ask
that you provide an ASCII Text file (should conform to the survey
record layout). If your data differs from the requested survey format,
please provide a record layout and any relevant documentation that
would be helpful in our analysis of your data.
3. Please submit electronic data files to [email protected] or mail
questionnaires to:
U.S. Census Bureau
P.O. Box 5000
Jeffersonville, IN 47199–5000
Attn: GOVS/CJP
For further information on electronic submissions, call Theresa Reitz or
Adam Bacon toll free at 1–800–352–7229.
4. Be sure to keep copies for your records of the data you submit.

FORM CJ-17L (9-12-2006)

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NOTE: IF MORE THAN 102 PERSONS MEET REQUIREMENTS A THROUGH D AS DESCRIBED BELOW

Section II – PERSON LEVEL DATA

☞

START HERE

Enter an identifying
number or first name
and last initial for all
juveniles meeting
ALL requirements
above. Use an
identifier that will
allow YOU to
reidentify each person
6 months from now, if
a callback is needed.

What is
this
person’s
sex?
Enter the
code on
the line.

Please COMPLETE a LINE on the table below for EACH
person who on Wednesday, October 25, 2006, was on
FORMAL court ordered juvenile probation supervision
(including juveniles on aftercare).

3.
What is
this
person’s
date of
birth?

M – Male
F – Female

4 – American Indian or Alaska Native
5 – Asian, not of Hispanic origin
6 – Native Hawaiian or other Pacific
Islander, not of Hispanic origin

If county and/or state are not known,
enter code 99 in the appropriate
box(es) below.
If this person resides in an
independent city which is located
outside of any "county" area, list the
independent city name in the
"county" box.

Line number

7 – Two or more races, not of Hispanic
origin – Specify
For definitions of these categories,
please refer to page 16.

Code

5.
On Wednesday, October 25, 2006,
in which county and state did this
person reside? Please print the full
county name. State name may be
abbreviated.

1011

Mo. Day Yr. Code

05 12 71

Specify Other only

County

State

Prince William

VA EX

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IF MORE PERSONS MEET REQUIREMENTS A THROUGH D ABOVE

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FORM CJ-17L (9-12-2006)

PHOTOCOPY PAGES 18 AND 19 TO MAKE MORE BLANK FORMS.

Section II – PERSON LEVEL DATA
Do NOT include in your count juveniles who were:
A. On PAROLE,
B. On INFORMAL non-court ordered probation, or
C. In a RESIDENTIAL FACILITY even if those juveniles were on formal court ordered probation.

6.
What is the most
serious offense
for which this
person was
adjudicated
delinquent?

If county and/or state are not known,
enter code 99 in the appropriate
box(es) below.
If this offense was committed in an
independent city which is located
outside of any "county" area, list the
independent city name in the
"county" box.

9.
Enter an identifying number
or first and last initial for this
person’s Probation Officer.
Use an identifier that will
allow you to reidentify this
Probation Officer
6 months from now, if a
callback is needed.

1 – On FORMAL Court Ordered
Probation Supervision
2 – On Intensive Supervision
Probation (ISP)
3 – Other – Specify on line

See offense
codes on pages
17 and 18.

Code

8.
On Wednesday, October 25, 2006,
what was this person’s probation
status?

Line number

Enter the code for
the most serious
offense resulting in
adjudication. If this
person was
adjudicated
delinquent for an
offense that is not
listed, enter 00
below.

In which county and state did this
person commit this offense?
Please print the full county name.
State name may be abbreviated.

County

State Code

City of Manassas

Specify Other only

K. Quartana

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Page 5

2.
What is
this
person’s
sex?
Enter the
code on
the line.
M – Male
F – Female

3.
What is
this
person’s
date of
birth?

4.
What is this person’s race?
Enter the code on the line.
1 – White, not of Hispanic origin
2 – Black or African American,
not of Hispanic origin
3 – Hispanic or Latino
(i.e., Mexican, Puerto Rican, Cuban,
Central or South American,
or other Spanish culture or origin)
4 – American Indian or Alaska Native
5 – Asian, not of Hispanic origin
6 – Native Hawaiian or other Pacific
Islander, not of Hispanic origin

5.
On Wednesday, October 25, 2006,
in which county and state did this
person reside? Please print the full
county name. State name may be
abbreviated.
If county and/or state are not known,
enter code 99 in the appropriate
box(es) below.
If this person resides in an
independent city which is located
outside of any "county" area, list the
independent city name in the
"county" box.

Line number

7 – Two or more races, not of
Hispanic origin – Specify

Line number

For definitions of these categories,
please refer to page 16.

Code

Mo. Day Yr. Code

Specify Other only

County

State

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Line number

Enter the code for
the most serious
offense resulting in
adjudication. If this
person was
adjudicated
delinquent for an
offense that is not
listed, enter 00
below.

In which county and state did this
person commit this offense?
Please print the full county name.
State name may be abbreviated.
If county and/or state are not known,
enter code 99 in the appropriate
box(es) below.
If this offense was committed in an
independent city which is located
outside of any "county" area, list the
independent city name in the
"county" box.

On Wednesday, October 25, 2006,
what was this person’s probation
status?

Enter an identifying number
or first and last initial for this
person’s Probation Officer.
Use an identifier that will
allow you to reidentify this
Probation Officer
6 months from now, if a
callback is needed.

1 – On FORMAL Court Ordered
Probation Supervision
2 – On Intensive Supervision
Probation (ISP)
3 – Other – Specify on line

See offense
codes on pages
17 and 18.

Code

County

State Code

Specify Other only

Line number

6.
What is the most
serious offense
for which this
person was
adjudicated
delinquent?

30
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2.
What is
this
person’s
sex?
Enter the
code on
the line.
M – Male
F – Female

3.
What is
this
person’s
date of
birth?

Line number

7 – Two or more races, not of
Hispanic origin – Specify

Line number

For definitions of these categories,
please refer to page 16.

Code

Mo. Day Yr. Code

Specify Other only

County

State

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Line number

Enter the code for
the most serious
offense resulting in
adjudication. If this
person was
adjudicated
delinquent for an
offense that is not
listed, enter 00
below.

On Wednesday, October 25, 2006,
what was this person’s probation
status?

1 – On FORMAL Court Ordered
Probation Supervision
2 – On Intensive Supervision
Probation (ISP)
3 – Other – Specify on line

See offense
codes on pages
17 and 18.

Code

County

State Code

Specify Other only

Line number

6.
What is the most
serious offense
for which this
person was
adjudicated
delinquent?

48
Page 9

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2.
What is
this
person’s
sex?
Enter the
code on
the line.
M – Male
F – Female

3.
What is
this
person’s
date of
birth?

Line number

7 – Two or more races, not of
Hispanic origin – Specify

Line number

1.
Enter an identifying
number or first name
and last initial for all
juveniles meeting
ALL requirements
above. Use an
identifier that will
allow YOU to
reidentify each person
6 months from now, if
a callback is needed.

For definitions of these categories,
please refer to page 16.

Code

Mo. Day Yr. Code

Specify Other only

County

State

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Line number

Enter the code for
the most serious
offense resulting in
adjudication. If this
person was
adjudicated
delinquent for an
offense that is not
listed, enter 00
below.

On Wednesday, October 25, 2006,
what was this person’s probation
status?

1 – On FORMAL Court Ordered
Probation Supervision
2 – On Intensive Supervision
Probation (ISP)
3 – Other – Specify on line

See offense
codes on pages
17 and 18.

Code

County

State Code

Specify Other only

Line number

6.
What is the most
serious offense
for which this
person was
adjudicated
delinquent?

66
Page 11

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2.
What is
this
person’s
sex?
Enter the
code on
the line.
M – Male
F – Female

3.
What is
this
person’s
date of
birth?

Line number

7 – Two or more races, not of
Hispanic origin – Specify

Line number

For definitions of these categories,
please refer to page 16.

Code

Mo. Day Yr. Code

Specify Other only

County

State

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Line number

Enter the code for
the most serious
offense resulting in
adjudication. If this
person was
adjudicated
delinquent for an
offense that is not
listed, enter 00
below.

On Wednesday, October 25, 2006,
what was this person’s probation
status?

1 – On FORMAL Court Ordered
Probation Supervision
2 – On Intensive Supervision
Probation (ISP)
3 – Other – Specify on line

See offense
codes on pages
17 and 18.

Code

County

State Code

Specify Other only

Line number

6.
What is the most
serious offense
for which this
person was
adjudicated
delinquent?

84
Page 13

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2.
What is
this
person’s
sex?
Enter the
code on
the line.
M – Male
F – Female

3.
What is
this
person’s
date of
birth?

Line number

7 – Two or more races, not of
Hispanic origin – Specify

Line number

For definitions of these categories,
please refer to page 16.

Code

Mo. Day Yr. Code

Specify Other only

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County

State

FORM CJ-17L (9-12-2006)

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Line number

Enter the code for
the most serious
offense resulting in
adjudication. If this
person was
adjudicated
delinquent for an
offense that is not
listed, enter 00
below.

On Wednesday, October 25, 2006,
what was this person’s probation
status?

1 – On FORMAL Court Ordered
Probation Supervision
2 – On Intensive Supervision
Probation (ISP)
3 – Other – Specify on line

See offense
codes on pages
17 and 18.

Code

County

State Code

Specify Other only

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FORM CJ-17L (9-12-2006)

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Line number

6.
What is the most
serious offense
for which this
person was
adjudicated
delinquent?

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The Federal Government uses the following definitions for the various racial categories.
White – A person having origins in any of the original peoples of Europe, the Middle East, or
North Africa.
Black or African American – A person having origins in any of the black racial groups of
Africa.
Hispanic or Latino – A person of Cuban, Mexican, Puerto Rican, South or Central American
or other Spanish culture or origin, regardless of race.
American Indian or Alaska Native – A person having origins in any of the original peoples
of North America and South America (including Central America) and who maintains tribal
affiliations or community attachment.
Asian – A person having origins in any of the original peoples of the Far East, Southeast Asia,
or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea,
Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Native Hawaiian or other Pacific Islander – A person having origins in any of the original
peoples of Hawaii, Guam, Samoa or other Pacific Islands.
Two or more races, not of Hispanic origin – Refers to combinations of two or more of the
following race categories: White, Black or African American, American Indian/Alaska Native,
Asian, Native Hawaiian or other Pacific Islander. In cases of Hispanic origin, regardless of
race(s), mark "Hispanic or Latino".

Thank you for completing this questionnaire. If you would like to give us any comments on
this form, please write them at the bottom of this page.
Please make copies for your own records of this completed questionnaire, so that if we
need to call you about an answer, you will be able to refer to your copies.
Please mail the completed form in the enclosed envelope to:
U.S. Census Bureau
P.O. Box 5000
Jeffersonville, IN 47199-5000
GOVS/CJP

Comments

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FORM CJ-17L (9-12-2006)

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OFFENSE CODE CARD
Census of Juveniles on Probation
This card presents a list of offenses divided into two main categories: (1) offenses for both
underage persons and for adults, and (2) possible offenses for underage persons only. Information
on this card may make it easier for you to classify juveniles on formal court-ordered probation
because of an offense.
In Section II, question 6, you are again referred to this card. There, you are asked to match each
young person’s offense to the category and type of offense on this card, note the two-digit code
number, and write that number in Section II, question 6, on the line for that person. Please record
the most serious offense for which this juvenile is on formal court-ordered probation as of
October 25, 2006.
Attempted offenses should be coded as if they were actual offenses, except for attempted murder
which should be coded as 20 (assault, aggravated).
Definitions of the offenses are provided on the back of this card.

OFFENSES FOR BOTH UNDERAGE PERSONS AND ADULTS
OFFENSES AGAINST PROPERTY

DRUG-RELATED OFFENSES

10 Arson
11 Auto theft, unauthorized use of auto, joyriding
12 Burglary, breaking and entering, household
larceny
13 Theft, non-household larceny
14 Property damage, vandalism
19 Other property offense

30 Drugs or narcotics, trafficking
31 Drugs or narcotics, possession
39 Other drug-related offense

OFFENSES AGAINST THE PUBLIC ORDER
40 Alcohol or drugs, driving under the
influence of
41 Obstruction of justice
42 Non-violent sex offense, statutory rape
43 Weapons-related offenses
49 Other public order offense

OFFENSES AGAINST PERSONS
20 Assault, aggravated
(include attempted murder)
21 Assault, simple
22 Kidnapping
23 Murder, manslaughter, negligent homicide
24 Violent sexual assault including forcible
rape
25 Robbery
29 Other person offense

PROBATION OR PAROLE VIOLATION
50 Probation or parole violation,
violation of a valid court order

POSSIBLE OFFENSES FOR UNDERAGE PERSONS ONLY
The behaviors identified below are considered offenses in this census ONLY IF THEY ARE ILLEGAL in your
state for underage persons:
60 Curfew violation
61 Incorrigible, ungovernable
62 Running away

63 Truancy
64 Alcohol: underage use, possession or consumption of
69 Other offense that is illegal for underage persons only

UNKNOWN OFFENSES
97 Unknown offense for both underage persons and adults
98 Unknown offense for underage persons only
99 Unknown offense
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DEFINITIONS OF OFFENSES
Alcohol or drugs, driving under the influence of –
Driving or operating a motor vehicle while under the
influence of alcohol, a drug or controlled substance.
Code 40.
Alcohol: underage use, possession, or
consumption of – Possession, use, or consumption of
alcohol by a minor. Code 64.
Arson – Actual or attempted intentional damaging or
destroying of property by fire or explosion, without the
owner’s consent. Code 10.
Assault, aggravated – An actual, attempted, or
threatened physical attack on a person that 1) involves
the use of a weapon or 2) causes serious physical
harm. Include attempted murder. Code 20. For assaults
with less than serious harm and without use of a
weapon – See Assault, simple.
Assault, simple – An actual, attempted, or threatened
physical attack on a person that causes less than
serious physical harm and without a weapon. Include
non-physical attacks causing the fear of an attack.
Code 21.
Auto theft, unauthorized use of auto, joyriding –
Actual or attempted unauthorized taking or use of a
motor vehicle, intending to deprive the owner of it
temporarily or permanently. Include joyriding and
grand theft auto. Code 11.
Burglary, breaking and entering, household
larceny – Actual or attempted unlawful entry of a
building, structure, or vehicle with intent to commit
larceny or another crime. Code 12.
Curfew violation – Violation of an ordinance
forbidding persons below a certain age from being in
public places during set hours. Code 60.
Drugs or narcotics, possession – Actual or
attempted purchase, possession or use of any illegal
drug or substance, excluding alcohol. Code 31.
Drugs or narcotics, trafficking – Actual or attempted
making, selling, or distributing of a controlled or illegal
drug or substance. Code 30.
Incorrigible, ungovernable – Being beyond the
control of parents, guardians, or custodians. Code only
if this is considered an offense in your state. Code 61.
Kidnapping – Actual or attempted unlawful
transportation or confinement of a person without
his/her consent (or, if a minor, consent of a guardian).
Code 22.
Murder/manslaughter/negligent homicide –
Causing the death of a person without legal
justification. Code 23. For attempted
murder/manslaughter – See Assault, aggravated.
Non-violent sex offense, statutory rape – Actual or
attempted offenses with a sexual element, without
violence. Include consensual sex with an underaged
person, prostitution, solicitation, indecent exposure,
pornography, and obscenity. Code 42. For sexual abuse
by a minor against another minor – See Violent sexual
assault.
Obstruction of justice – Any act that intentionally
impedes the enforcement of a law or court order.
Examples: Escape from confinement, contempt of
court, perjury, failing to report a crime, nonviolently
resisting arrest, and bribery. Code 41. See
Probation/parole violation.

Other drug-related offense – Use this code if the drug
offense is not specifically listed on the offense code card
or definitions. Examples include: possession of drug
paraphernalia, visiting a place where drugs are found, etc.
Code 39.
Other offense that is illegal for underage persons
only – Use this code if the drug offense is not illegal for
adults and is not specifically listed on the offense code
card or definitions. Examples include: underage
smoking, unruliness in school, etc. Code 69.
Other person offense – Use this code if the person
offense is not specifically listed in the table or
definitions. Examples include: harassment, coercion,
reckless endangerment, etc. Code 29.
Other property offense – Use this code if the property
offense is not specifically listed in the table or definitions.
Examples include: trespassing, selling stolen property,
possession of burglar’s tools, fraud, etc. Code 19.
Other public order offense – Use this code if the
public order offense is not specifically listed in the table
or definitions. Examples include: cruelty to animals,
disorderly conduct, traffic offenses, etc. Code 49.
Probation or parole violation, violation of valid
court order – Acts that disobey or go against the
conditions of probation or parole. Examples: failure to
participate in a specific program, failure to appear for
drug tests or meetings, and failure to pay restitution.
Code 50.
Property damage, vandalism – Actual or attempted
damaging or destroying of property of a person or
public property. Code 14. For destroying or damaging
by fire or explosion – See Arson.
Robbery – Actual or attempted unlawful taking of
property in the direct possession of a person by force or
threat of force. Include purse snatching with force and
carjacking. Code 25. For purse snatching without force –
See Theft/non-household larceny.
Running away – Leaving the custody and home of
parents or guardians without permission and failing to
return within a reasonable length of time. Code only if
this is considered an offense in the state in which it
occurred. Code 62. For running away from a facility –
See Obstruction of justice.
Theft, non-household larceny – Actual or attempted
taking of property (other than an auto) from a person
without force or deceit. Include shoplifting, pickpocketing,
and purse snatching without force. Code 13.
• For purse snatching with force – See Robbery.
• For theft using deceit – See Other property offense.
• For household larceny – See Burglary, breaking and
entering, household larceny.
Truancy – Violation of a compulsory school attendance
law. Code only if this is considered an offense in your
state. Code 63.
Violent sexual assault including forcible rape –
Actual or attempted sexual intercourse or sexual
assaults against a person against her/his will by force or
threat of force. Includes incest, sodomy, and sexual
abuse by a minor against another minor. Code 24. See
also Non-violent sex offense, statutory rape.
Weapons-related offenses – Actual or attempted
illegal sale, distribution, manufacture, alteration,
transportation, possession, or use of a deadly or
dangerous weapon or accessory. Code 43.
FORM CJ-17L (9-12-2006)

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File Type	application/pdf
File Modified	2006-11-16
File Created	2006-10-18