INTREST Page of CR-465 (2/19)(cs) Criminal Rule 3, 32.6; Civil Rule 69(a)&(h) RESTITUTION JUDGMENT AS 12.55.045(l) & .051(f); AS 12.30.075; Admin. Bulletin 43 IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA AT STATE OF ALASKA ) ) vs. ) Defendant: ) ) CASE NO. CR DOB: APSIN: ) ) RESTITUTION JUDGMENT IT IS ORDERED THAT: 1. The defendant shall pay restitution to the following recipient(s) for the amounts shown below: Restitution Recipients Owed to MoA 1 DKT CR465ANC.1 Claim/Account No.* Amount A. $ B. $ C. $ D. $ E. $ Others listed on attached Addendum. TOTAL THIS PAGE: $ *Include any claim or account number for insurance companies, banks, pawnshops, etc., if known. This restitution judgment is payable to the State of Alaska for: game animal restitution under AS 16.05.925(b) [docket code CR465FO] nonindigenous fish restitution under AS 16.35.210 [docket code CR465FO] other restitution payable to the State [docket code CR465FO] 2. The restitution is due immediately. Find payment instructions at: http://www.courts.alaska.gov/ trialcourts/restitution.htm, or contact your local court clerk. 3. The defendant must apply for an Alaska Permanent Fund Dividend, if eligible, each year until restitution is paid in full. The Restitution Judgment will continue to be civilly enforceable after probation expires and after any suspended entry of judgment in this case. (AS 12.55.045(l)) 4. Interest will accrue on the principal amount due at the rate specified in AS 09.30.070(a) from date of loss: date of this judgment: 5. The restitution due is owed jointly and severally with restitution ordered to be paid by the following co-defendants: (Names and Case Numbers) 6. If bail was forfeited in this case, any forfeited funds shall be applied to restitution, and the clerk is ordered to enter a judgment (CR-465.2) against the defendant in favor of the state for that amount. I certify tha t on a copy of this judgment was sent to: Prosecutor Def Atty Defendant DPS DOC Probation restitution@akcourts.us (Fiscal Operations) MoA Treasury Clerk: / Judge Date 1 If the Municipality of Anchorage is the victim in the case the box should be checked. American LegalNet, Inc. www.FormsWorkFlow.com