This is a form for the sex offender rules of supervision for probation, probation with restrictive conditions (e.g. intermediate punishment), and parole used in Adams County, PA.
The form is used by the Department of Probation Services and the defendant. The form should be reviewed with the defendant by the defense attorney. A probation officer or other representative will require the defendant to sign the form if the court has imposed "sex offender" rules or conditions as part of the sentence.
Reference: These Rules are incorporated into Local Rule 705.1, which has been adopted by the Court.