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EXHIBIT B <br /> INDIAN RIVER COUNTY PROBATION OFFICE <br /> 1840 25TH STREET, ROOM 118 , VERO BEACH, FLORIDA <br /> (772) 567 - 8000 Ext, 1316 / 1317 / 1310 <br /> CASE NAME : CASE # <br /> HOURS TO BE WORKED COMPLETION DATE <br /> RECORD OF COMMUNITY SERVICE HOURS <br /> DATE TIME IN TIME OUT # OF HOURS SUPERVISORS SIGNATURE <br /> PROVIDER / NON-PROFIT AGENCY <br /> ADDRESS <br /> VOLUNTEER COORDINATOR <br /> PHONE # <br /> COMMUNITY SERVICE IS VOLUNTEER (NOT PAID) WORK FOR A CHURCH, A <br /> GOVERNMENT AGENCY OR A NON-PROFIT ORGANIZATION. <br /> CSH.FORM. 10/02 <br />