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Ministry of the Attorney General Ministere du Procureur general

VICTIM IMPACT STATEMENT

Victim's Name

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First Name

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If you are not the direct victim of the crime please describe your relationship to the case:

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Accused's Name (if known)

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Investigating Officer .. ~

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(Family Name, Rank, Badge Number) TeI.!N°

Would you like to read this statement to the judge?

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NO

PLEASE RETURN THIS COMPLETED

FORM TO THE POLICE

After you have returned your completed Victim Impact Statement to the investigating officer, a copy will be made for the accused and his/her lawyer and you may be crossexamined on the contents.

H is important that you keep in touch with the police respecting upcoming court dates
since the offender may plead guilty at any time and your Statement must be filed with the court as soon as possible after a finding of guilt.
Please remember that the Victim Impact Statement is about you, not the accused.
• Please focus on providing a description of the impact of the crime on your life. Quite understandably, emotions run high in these situations but it is important not to include vengeful comments, criticisms or rumours about the accused. Such comments will not assist the judge and may detract from your statement. Please indicate any probation conditions that would be helpful for you, in your Victim Impact Statement, including if you do or do not want contact with the accused. Please do not include suggestions about the sentence. Please try not to describe the crime in your Victim Impact Statement. The judge has already found the accused guilty based on what has been found to have occurred. Therefore, it is not helpful, at this point, to offer more information about the circumstances of the offence.
EMOTIONAL LOSS Please describe how this offence has affected you? (Please attach extra sheets, if needed)

1.

2.

PHYSICAL INJURY
Please list the injuries and the treatment you received, including any permanent Disabilities. (Please attach extra sheets, if needed.)

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Ministry of the Attorney General Ministere du Procureur general

VICTIM IMPACT STATEMENT

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Victim's Name

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First Name

Family Name

If you are not the direct victim of the crime please describe your relationship to the case:

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Accused's Name (if known)

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Family Name

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Investigating Officer
(Family Name, Rank, Badge Number) Tel.lN°

Would you like to read this statement to the judge?

0 YES

NO

PLEASE RETURN THIS COMPLETED

FORL'1 TO THE POLICE

After you have returned your completed Victim Impact Statement to the investigating officer, a copy will be made for the accused and his/her lawyer and you may be crossexamined on the contents.

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