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Adult Diversion Report Form

  1. Contact Information

    Brian M McIntrye
    Cochise County Attorney
    Telephone No.: (520)432-8700
    Fax No.: (520)432-8778

  2. Instruction

    Complete as directed, (Failure to report can result in revocation from the program,)

  3. I Live:
  4. Means of Transportation
  5. Note Per Hour/Week/Month

  6. Have you been arrested during the past month?
  7. Have you had any problems/difficulties during the past month?
  8. Have you made a payment on restitution and/or supervision fee?

    Payments Are Now Exclusively Accepted On-Line

  9. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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  11. This field is not part of the form submission.