CR-3419 (Rev. 02-19) Page 1 of 2 RDA 1167 IN THE CRIMINAL/CIRCUIT COURT FOR COUNTY, TENNESSEE Case Number: Count # Counsel for the State: Judicial District: Judicial Division: Counsel for the Defendant: Co-Counsel for the Defendant: Retained Pub Def Appt Private Atty Appt State of Tennessee Counsel Waived Pro Se vs. Defendant: Alias: Date of Birth: Sex: Race: SSN: Driver License #: Issuing State: State ID #: County Offender ID # (if applicable): TDOC #: Relationship to Victim: Victim222s Age: State Control #: Arrest Date: Indictment Filing Date: JUDGMENT Original Amended Corrected Come the parties for entry of judgment. On the day of , 20 , the defendant : Indictment: Class (circle one) 1st A B C D E Felony Misdemeanor Indicted Offense Name: Indicted Offense TCA 247: Amended Offense Name: Amended Offense TCA 247: Offense Date: County of Offense: Conviction Offense Name: Conviction Offense TCA 247: Conviction: Class (circle one) 1st A B C D E Felony Misdemeanor Sentence Imposed Date: After considering the evidence, the entire record , and in the case of sentencing, all factors in Tennessee Code Annotated Title 40 , Chapter 35, all of which are incorporated by reference herein, it is ORDERED and ADJUDGED that the conviction described above is imposed hereby and that a s entence and costs are imposed as follows: Pretrial Jail Credit Period(s): From to From to From to From to From to From to It is not the intent of the court for duplication of Jail Credit to be applied to consecutive sentences Pled Guilty Pled Nolo Contendere Pled Guilty 226 Certified Question Findings Incorporated by Reference Dismissed Nolle Prosequi with costs Nolle Prosequi without costs Is found: Guilty Not Guilty Not Guilty by Reason of Insanity Jury Verdict Bench Trial Merged with Count: Offender Status Release Eligibility for Felony Offense (Check One) (Check One) Mitigated Mitigated 20% 247 40-35-501(i) 100% Agg Rob 85% Agg Child Neg/En 70% Standard Mitigated 30% Multiple Rapist 100% Agg Rob w/Prior 100% Agg Child Neg/En 85% Multiple Standard 30% Child Rapist 100% 247 39-17-1324(a), (b) 100% Agg Vehicular Homicide 60% Persistent Multiple 35% Agg Rapist 100% Mult 247 39-17-1324(j) 100% Carjacking 75% Career Persistent 45% Child Predator 100% Agg Assault w/Death 75% 24740-35-501(u) 85% Career 60% 247 39-13-518 100% Att 1st Deg Murder w/SBI 85% 1st Degree Murder Pre 1989 Reform Act 1989 Drug Free Zone Gang Related Repeat Violent Off Concurrent with: Consecutive to: Sentenced To: TDOC County Jail Workhouse Sentence Length: Years Months Days Hours Life Life w/out Parole Death Mandatory Minimum Sentence Length: 247247 39-17-417, 39-13-513, 39-13-514, or 39-17-432 in Prohibited Zone 247 55-10-401 DUI 4th Offense 247 39-17-1324 Possession/Employment of Firearm 247247 40-39-208, -211 Violation of Sex Offender Registry Meth 247247 (39-17-434, -417, -418) Period of incarceration to be served prior to release on probation or Community Corrections: Months Days Hours Minimum service prior to eligibility for work release, furlough, trusty status and rehabilitative programs: % (Misdemeanor or Split Confinement Only) Alternative Sentence: Sup Prob Unsup Prob Comm Corr Prob Sup By Comm. Corr (CHECK ONE BOX) Years Months Days Effective: WAS DRUG/RECOVERY COURT ORDERED AS A CONDITION OF THE ALTERNATIVE SENTENCE? Yes No Judge222s Name Judge222s Signature American LegalNet, Inc. www.FormsWorkFlow.com CR-3419 (Rev. 02-19) Page 2 of 2 RDA 1167 Judge222s Name Judge222s Signature Date of Entry of Judgment Counsel for State/Signature (optional) Defendant/Defendant222s Counsel/Signature (optional) I , clerk, hereby certify that, before entry by the court, a copy of this judgment was made available to the party or parties who did not provide a signature above. IN THE CRIMINAL/CIRCUIT COURT FOR COUNTY, TENNESSEE Case Number: Count # Judicial District: Judicial Division: State of Tennessee vs. Defendant: Alias: Date of Birth: Sex: Race: SSN: CONTINUATION OF JUDGMENT Original Amended Corrected The Defendant having been found guilty is rendered infamous and ordered to provide a biological specimen for the purpose of D NA analysis. Pursuant to 39-13-521, the defendant is ordered to provide a biological specimen for the purpose of HIV testing. Pursuant to 39-13-524 or 39-13-518, the defendant is sentenced to community supervision for life following sentence expiration. Pursuant to Title 68, Chapter 11, Part 10, 71-6-117, or 71-6-119, the clerk shall forward this judgment to the Department of Health. Special Conditions: Restitution: Victim Name Address Total Amount $ Per Month $ Court Ordered Fees and Fines: Costs to be Paid by $ Court Costs Defendant State $ Fine Assessed $ Traumatic Brain Injury Fund (68-55-301 et seq.) $ Drug Testing Fund (TN Drug Control Act) $ CICF $ Sex Offender Tax $ Other: Unpaid Community Service: Hours Days Weeks Months American LegalNet, Inc. www.FormsWorkFlow.com