The following form, to be furnished by the county, shall be used in transmitting the required data for any individual placed on probation under the supervision of the Division of Community Corrections of the Department of Corrections:
“Circuit Court, County of. To the Mississippi Department of Corrections: You are hereby notified that at the term, 2, of the circuit court, Judge presiding, the following named person was tried, convicted and sentenced to a term in the State Penitentiary. The sentence was suspended and the person was placed on probation: Name Alias Date of sentence Crime Term of sentence Sex Race Appealed Remarks: Give brief summary of crime committed. Dated, 2. Clerk.”