APPLICATION FOR SENTENCE REVIEW Indictment No. Superior Court (NAME) VS STATE OF GEORGIA The above named applicant hereby applies to the Superior Courts Sentence Review Panel of Georgia for review of the felony sentence(s) imposed in the Superior Court of County on , 20wherein the sentence or consecutive sentences total twelve (12) years or more. The Clerk will please forward a copy of the sentence(s) of the Court, the indictment(s), pre-sentence or post-sentence investigation made by the Court or by the probation officer and a copy of the criminal record of the applicant. Application for Review of Sentence is made pursuant to OCGA 17-10-6. Application may be filed by the defendant or attorney. Please indicate whether you are the ATTORNEY DEFENDANT Please indicate below the name and address of the person filing this Complete the information below concerning the defendant: Application: State I.D. Number: Date of Birth: Social Security Number DATE SIGNATURE OF APPLICANT PLEASE RETURN THIS FORM TO THE SUPERIOR COURT CLERK OF THE COUNTY IN WHICH THE DEFENDANT WAS SENTENCED A1(b)-7/93