A.C.A. # of Offense/ Name of Offense+ Case # A.C.A. # of OriginalCharged Offense ATN Offense was Appeal from District Court Probation/SIS Revocation+ Offense DateOffense is Offense Classification Number of Counts: Criminal History Score Seriousness LevelDefendant Presumptive Sentence Defendant Sentence 247 Victim Info Age Sex Race & Ethnicity Defendant voluntarily, intelligently, and knowingly entered a Sentence is a Departure Sentence Departure is Durational or Dispositional Departure Reason Aggravating # or Mitigating # . For Agg. #17 or Mit. #9, or if departing from guidelines, please explain: Sentence will run A.C.A. # of Offense/ Name of Offense+ A.C.A. # of OriginalCharged Offense ATN Offense was Appeal from District Court Probation/SIS Revocation+ Offense DateOffense is Offense Classification Number of Counts: Criminal History Score Seriousness LevelDefendant Presumptive Sentence Defendant Sentence Victim Info Age Sex Race & Ethnicity Defendant voluntarily, intelligently, and knowingly entered a Sentence is a Departure Sentence Departure is Durational or Dispositional Departure Reason Aggravating # or Mitigating # . For Agg. #17 or Mit. #9, or if departing from guidelines, please explain: Sentence will run: Offense #: Offense #: American LegalNet, Inc. www.FormsWorkFlow.com