In the Criminal/Circuit Court of ______County, Tennessee

IN THE CRIMINAL/CIRCUIT COURT OF ______COUNTY, TENNESSEE

Case Number: ______Count # ______Attorney for the State:______

Judicial District: ______Judicial Division: ______Counsel for Defendant:______

State of Tennessee Retained Appointed Public Defender

vs. Counsel Waived Pro Se

Defendant: ______Alias:______

Date of Birth: ______Sex: ______Race: ______SSN:______

Indictment Filing Date: ______TDOC # ______State Control # ______

State ID # ______CountyOffender ID # ______

JUDGMENT

Original Amended Corrected

On the ______day of ______, ______, the defendant:

Pled Guilty Dismissed/Nolle Prosequi

Nolo Contendere Retired/Unapprehended Defendant

Guilty Plea – Pursuant to 40-35-313

Is found: Guilty Not Guilty

Jury Verdict Not Guilty by Reason of Insanity

Bench Trial

Indictment: Class (circle one)1stABCDE Felony Misdemeanor

Offense: ______

Amended Charge: ______

Offense Date: ______County: ______

Conviction Offense: ______

Is this conviction offense methamphetamine related? Yes No

TCA #: ______Sentence Imposed Date: ______

Conviction: Class (circle one)1stABCDE Felony Misdemeanor

After considering the evidence, the entire record, & all factors in T.C.A. Title 40 Chapter 35, all of which are incorporated by reference herein, the Court’s findings & rulings are:

Sentence Reform Act of 1989

Offender Status (Check One) Release Eligibility (Check One)

Mitigated Mitigated 20% Multiple Rapist 100%

Standard Mitigated 30% Child Rapist 100%

Multiple Standard 30% Repeat Violent 100%

Persistent Multiple 35% Child Predator 100%

Career Persistent 45%

Repeat Violent Career 60%

Violent 100%

Pretrial Jail Credit Period(s):

From ______to ______

From ______to ______

From ______to ______

From ______to ______

Concurrent with:

______

Consecutive to:

Sentenced To:TDOCCountyJail Workhouse

Sentence Length:______Years ______Months ______Days ______Hours ______WeekendsLifeLife w/out ParoleDeath

Mandatory Minimum Sentence Length: ______39-17-417, 39-13-513, 39-13-514 in Drug Free Zoneor______55-10-401 DUI 4th Offense

or ______39-17-1324 Possession/Employment of Firearm

Period of incarceration to be served prior to release on probation:______Months______Days______Hours ______Weekends

Minimum service prior to eligibility for work release, furlough, trusty status and rehabilitative programs:______% (Misdemeanor Only)

Alternative Sentence:ProbationDiversionDrug CourtCommunity Based Alternative - Specify ______Years ______Months ______Days Effective: ______

Court Ordered Fees and Fines: Cost to be Paid by

$ ______Court Costs Defendant State

$______Fine Assessed

$ ______Traumatic Brain Injury Fund (Drag Racing)

$ ______Drug Testing Fund (TN Drug Control Act)

$ ______CICF $______Sex Offender Tax

$ ______Other:______

The Defendant having been found guilty is rendered infamous and ordered to provide a biological specimen for the purpose of DNA analysis.

Pursuant to 39-13-521 the defendant is ordered to provide a biological specimen for the purpose of HIV testing.

Special ConditionsPursuant to 39-13-524 the defendant is sentenced to community supervision for life following sentence expiration.

Restitution:Victim Name______

Address______

______

Total Amount $______Per Month $______

Unpaid Community Service: _____Hours _____Days _____Weeks _____Months

1st Degree Murder

Drug Free Zone

Gang Related

Comes the District Attorney General for the State and the defendant with counsel of record for entry of judgment.

CR-3419 (Rev. 9/08)White – Criminal Court ClerkCanary – TN Dept. of Correction/SMSPink – AOCGoldenrod – JailRDA 1167