Pound-force per square inch Report Extended Form

Presentence Investigation Contact form

Fill out entirely and effectively. If you are unsure of an answer, estimate for the best of your understanding and note that it is an estimate. All information will be verified and any mistakes will be mentioned to the The courtroom. Defendant Data

Full (Legal) Name: ____________________________________________________________

_____

Alias or Moniker: ________________________________________________________________

Current Address: _____________________________________Phone: _______________________

City______________________________________State________Zip__

______________________

Long term Address: ____________________________________________________________

___

(if different from above)

Date of Birth: ____ /_____/_____ Sociable Security No . ______________________________________

Town & Express of Birth_______________________________________________________

_________

Age______Race_____Sex____Height_______Weight_______Eyes_____

Hair_________________

IDENTIFICATION Marks (inc. tattoos, scars) ________________________________________________________

____________________________________________________________

____________________

US Citizen_____Y______N Peculiar Status: ______________________________________________

Driver's License Number ____________________State of Issue________License Status_____________

Contact Persons

1 . Name__________________________________Relation____________

Address___________________________________________________

Phone____________________________________________________

2 . Name__________________________________Relation____________

Address___________________________________________________

Phone__________________________________________________

Please explain what you would to be arrested for this offense. This is the version in the offense and your statements will be directly cited in this Pre-Sentence Report increase in submitted to the Court. You can even make virtually any statements you want in regard to your emotions about the offense and any other details that you feel is important regarding the wrongdoing. (You might use another linen of newspaper if necessary)

Lawbreaker Orientation

Age of first certainty? ___________________________________________________ Ever before convicted as an adult underneath the age of 18? _______________________________

Ever been placed in the Indiana Males or Ladies School? __________________________

Do you have a prior Felony dedication in Indiana? ______________________________

Are you currently arrested in another state besides Indiana or possibly a county besides Montgomery? _________If yes, where? ______________________________________ ____________________________________________________________

_________

Ever before charged using a Battery or another violent crime? _________________________

Ever before charged with Escape as an Adult or Runaway as a Juvenile? _________________

Ever had a jail or perhaps prison write-up for discipline? ________________________________

If you do, for what? And what was the sanction? _________________________________

Ever had a Felony lowered to a Misdemeanor at Sentencing? ____________________

During the time of the present crime were you on Copie? _______________________ On Parole? ____________________________________________________________

Have you been about Probation ahead of? __________where? ________________________

Have you been upon Parole prior to? ___________from what prison? _________________

Have you acquired Probation or perhaps Parole Violations? _________________________________

Have you ever had the Probation or perhaps Parole Terminated? _____________________________

Can be your driver's license suspended? _________Has it recently been before? _________________

Ever been an associate of a teen or mature gang? ______________________________ If yes, how much time? ________________Name of gang____________________________

Are there relatives or perhaps close friends at present in the...

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