IN THE GENERAL SESSIONS CRIMINAL COURT SHELBY COUNTY, TENNESSEE EDWARD L. STANTON, JR., CLERK PRO TEMPORE DIVISION_____________ ____________________________________________________________________________________________________________ STATE OF TENNESSEE VS _____________________________________ DEFENDANT * * * CASE NO. _____________________________________________ * ____________________________________________________________________________________________________________ ORDER OF SENTENCE ____________________________________________________________________________________________________________ This cause having come on to be heard before the undersigned Judge, the above named defendant having duly entered a plea to the crime(s) charged against him,and it satisfactorily appearing to the Court that the evidence warrants an adjudication of guilt of the following offense(s): ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ IT IS THEREFORE, ORDERED, ADJUDGED AND DECREED that the defendant is found guilty of the charged offense(s) and is hereby sentenced as follows: Charge: ________________________________________________________________________________________________________ (A)___________Pay a fine of _______________________dollars and court costs. (B)___________Serve __________________months and _______________________days in jail of which time ____________months _____________days are suspended. (C)___________Given credit for ____________days and ______________hours for time served. (D)___________That the defendant shall be placed on ________________________probation for __________months ____________days. (E)___________Required to attend Alcohol Safety School. (F)___________Revocation of operator's license for _____________years and _________months. (G)___________Be allowed ________________days to pay fine and costs. (H)___________Other: ___________________________________________________________________________________________ (I) ___________Brain/Injury Fund _______________________________________________________________________________ Charge: ________________________________________________________________________________________________________ (A)___________Pay a fine of _______________________dollars and court costs. (B)___________Serve __________________months and _______________________days in jail of which time ____________months _____________days are suspended. (C)___________Given credit for ____________days and ______________hours for time served. (D)___________That the defendant shall be placed on ________________________probation for __________months ____________days. (E)___________Required to attend Alcohol Safety School. (F)___________Revocation of operator's license for _____________years and _________months. (G)___________Be allowed ________________days to pay fine and costs. (H)___________Other: ___________________________________________________________________________________________ (I) ___________Brain/Injury Fund _______________________________________________________________________________ _____________________________________________ JUDGE _____________________________________________ DATE and and and and APPROVED: __________________________________________ ATTORNEY FOR PROSECUTION __________________________________________ DEFENDANT __________________________________________ ATTORNEY FOR DEFENDANT __________________________________________ B. P. R. NUMBER American LegalNet, Inc. www.FormsWorkFlow.com Charge: ________________________________________________________________________________________________________ (A)___________Pay a fine of _______________________dollars and court costs. (B)___________Serve __________________months and _______________________days in jail of which time ____________months _____________days are suspended. (C)___________Given credit for ____________days and ______________hours for time served. (D)___________That the defendant shall be placed on ________________________probation for __________months ____________days. (E)___________Required to attend Alcohol Safety School. (F)___________Revocation of operator's license for _____________years and _________months. (G)___________Be allowed ________________days to pay fine and costs. (H)___________Other: ___________________________________________________________________________________________ (I) ___________Brain/Injury Fund _______________________________________________________________________________ Charge: ________________________________________________________________________________________________________ (A)___________Pay a fine of _______________________dollars and court costs. (B)___________Serve __________________months and _______________________days in jail of which time ____________months _____________days are suspended. (C)___________Given credit for ____________days and ______________hours for time served. (D)___________That the defendant shall be placed on ________________________probation for __________months ____________days. (E)___________Required to attend Alcohol Safety School. (F)___________Revocation of operator's license for _____________years and _________months. (G)___________Be allowed ________________days to pay fine and costs. (H)___________Other: ___________________________________________________________________________________________ (I) ___________Brain/Injury Fund _______________________________________________________________________________ Charge: ________________________________________________________________________________________________________ (A)___________Pay a fine of _______________________dollars and court costs. (B)___________Serve __________________months and _______________________days in jail of which time ____________months _____________days are suspended. (C)___________Given credit for ____________days and ______________hours for time served. (D)___________That the defendant shall be placed on ________________________probation for __________months ____________days. (E)___________Required to attend Alcohol Safety School. (F)___________Revocation of operator's license for _____________years and _________months. (G)___________Be allowed ________