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Judgment And Sentence - Prison Form. This is a Washington form and can be use in Felony Judgment And Sentence Statewide.
Tags: Judgment And Sentence - Prison, CR 84.0400, Washington Statewide, Felony Judgment And Sentence
Superior Court of Washington County of State of Washington, Plaintiff, No. vs. Felony Judgment and Sentence -Prison (FJS) ______________________________________, Defendant. DOB PCN: SID: [ ] Clerk’s Action Required, para 2.1, 4.1, 4.3, 5.2, 5.3, 5.5 and 5.7 [ ] Defendant Used Motor Vehicle [ ] Juvenile Decline [ ] Mandatory [ ] Discretionary I. Hearing 1.1 The court conducted a sentencing hearing this date; the defendant, the defendant's lawyer, and the (deputy) prosecuting attorney were present. II. Findings 2.1 Current Offenses: The defendant is guilty of the following offenses, based upon [ ] guilty plea (date) ____________ [ ] jury-verdict (date) ____________ [ ] bench trial (date) ____________: Count Crime RCW (w/subsection) Class Date of Crime Class: FA (Felony-A), FB (Felony-B), FC (Felony-C) (If the crime is a drug offense, include the type of drug in the second column.) [ ] Additional current offenses are attached in Appendix 2.1a. The jury returned a special verdict or the court made a special finding with regard to the following: GV [ ] For the crime(s) charged in Count ____________, domestic violence was pled and proved. RCW 10.99.020. [ ] The defendant used a firearm in the commission of the offense in Count ______________. RCW 9.94A.602, 9.94A.533. [ ] The defendant used a deadly weapon other than a firearm in committing the offense in Count ____________ _______________________. RCW 9.94A.602, 9.94A.533. Felony Judgment and Sentence (FJS) (Prison)(Nonsex Offender) (RCW 9.94A.500, .505)(WPF CR 84.0400 (06/2012)) Page 1 of 10 American LegalNet, Inc. www.FormsWorkFlow.com [ ] Count _______________________, Violation of the Uniform Controlled Substances Act (VUCSA), RCW 69.50.401 and RCW 69.50.435, took place in a school, school bus, within 1000 feet of the perimeter of a school grounds or within 1000 feet of a school bus route stop designated by the school district; or in a public park, public transit vehicle, or public transit stop shelter; or in, or within 1000 feet of the perimeter of a civic center designated as a drug-free zone by a local government authority, or in a public housing project designated by a local governing authority as a drug-free zone. [ ] The defendant committed a crime involving the manufacture of methamphetamine, including its salts, isomers, and salts of isomers, when a juvenile was present in or upon the premises of manufacture in Count _____________________________. RCW 9.94A.605, RCW 69.50.401, RCW 69.50.440. [ ] Count ________________ is a criminal street gang-related felony offense in which the defendant compensated, threatened, or solicited a minor in order to involve that minor in the commission of the offense. RCW 9.94A.833. [ ] Count ____________ is the crime of unlawful possession of a firearm and the defendant was a criminal street gang member or associate when the defendant committed the crime. RCW 9.94A.702, 9.94A.____. [ ] The defendant committed [ ] vehicular homicide [ ] vehicular assault proximately caused by driving a vehicle while under the influence of intoxicating liquor or drug or by operating a vehicle in a reckless manner. The offense is, therefore, deemed a violent offense. RCW 9.94A.030. GY [ ] In Count _______, the defendant had (number of) ______ passenger(s) under the age of 16 in the vehicle. RCW 9.94A.533. [ ] Count __________ involves attempting to elude a police vehicle and during the commission of the crime the defendant endangered one or more persons other than the defendant or the pursuing law enforcement officer. RCW 9.94A.834. [ ] In Count ______________ the defendant has been convicted of assaulting a law enforcement officer or other employee of a law enforcement agency who was performing his or her official duties at the time of the assault, as provided under RCW 9A.36.031, and the defendant intentionally committed the assault with what appeared to be a firearm. RCW 9.94A.831, 9.94A.533. [ ] Count ________ is a felony in the commission of which the defendant used a motor vehicle. RCW46.20.285. [ ] The defendant has a chemical dependency that has contributed to the offense(s). RCW 9.94A.607. [ ] In Count ______, assault in the 1st degree (RCW 9A.36.011) or assault of a child in the 1st degree (RCW 9A.36.120), the offender used force or means likely to result in death or intended to kill the victim and shall be subject to a mandatory minimum term of 5 years (RCW 9.94A.540). [ ] Counts __________________ encompass the same criminal conduct and count as one crime in determining the offender score. RCW 9.94A.589. [ ] Other current convictions listed under different cause numbers used in calculating the offender score are (list offense and cause number): DV* Crime Cause Number Court (county & state) Yes 1 . 2 . * DV: Domestic Violence was pled and proved. [ ] Additional current convictions listed under different cause numbers used in calculating the offender score are attached in Appendix 2.1b. Felony Judgment and Sentence (FJS) (Prison)(Nonsex Offender) (RCW 9.94A.500, .505)(WPF CR 84.0400 (06/2012)) Page 2 of 10 American LegalNet, Inc. www.FormsWorkFlow.com 2.2 Criminal History (RCW 9.94A.525): Crime Date of Crime Date of Sentence Sentencing Court (County & State) A or J Adult, Juv. Type of Crime DV* Yes 1 2 3 4 5 * DV: Domestic Violence was pled and proved. [ ] Additional criminal history is attached in Appendix 2.2. [ ] The defendant committed a current offense while on community placement/community custody (adds one point to score). RCW 9.94A.525. [ ] The prior convictions listed as number(s) ___________, above, or in appendix 2.2, are one offense for purposes of determining the offender score (RCW 9.94A.525) [ ] The prior convictions listed as number(s) ____________, above, or in appendix 2.2, are not counted as points but as enhancements pursuant to RCW 46.61.520. 2.3 Sentencing Data: Count Offender Serious- Standard No. Score ness Range (not including Level Plus Total Standard Enhancements* Range (including Maximum Term enhancements) enhancements) * (F) Firearm, (D) Other deadly weapons, (V) VUCSA in a protected zone, (VH) Veh. Hom, see RCW 46.61.520, (JP) Juvenile present, (CSG) criminal street gang involving minor, (AE) endangerment while attempting to elude, (ALF) assault law enforcement with firearm, RCW 9.94A.533(12), (P16) Passenger(s) under age 16. [ ] Additional current offense sentencing data is attached in Appendix 2.3. For violent offenses, most serious offenses, or armed offenders, recommended sentencing agreements or plea agreements are [ ] attached [ ] as follows: ______________________________________________________. 2.4 [ ] Exceptional Sentence. The court finds substantial and compelling reasons that justify an exceptional sentence: [ ] below the standard range for Count(s) _______________. [ ] above the standard range for Count(s) _______________. Felony Judgment and Sentence (FJS) (Prison)(Nonsex Offender) (RCW 9.94A.500, .505)(WPF CR 84.0400 (06/2012)) Page 3 of 10 American LegalNet, Inc. www.FormsWorkFlow.com [ ] The defendant and state stipulate that justice is best served by imposition of the exceptional sentence above the standard range and the court finds the exceptional sentence furthers and is consistent with the interests of justice and the purposes of the sentencing reform act. [ ] Aggravating factors were [ ] stipulated by the defendant, [ ] found by the court after the defendant waived jury trial, [ ] found by jury, by special interrogatory. [ ] within the standard range for Count(s) _________, but served consecutively to Count(s) ____________. Findings of fact and conclusions of law are attached in Appendix 2.4. [ ] Jury’s special interrogatory is attached. The Prosecuting Attorney [ ] did [ ] did not recommend a similar sentence. 2.5 Legal Financial Obligations/Restitution. The court has considered the total amount owing, the defendant's present and future ability to pay legal financial obligations, including the defendant's financial resources and the likelihood that the defendant's status will change. (RCW 10.01.160). The court makes the following specific findings: [ ] The following extraordinary circumstances exist that make restitution inappropriate (RCW 9.94A.753): ___________________________________________________________________________________ . [ ] The defendant has the present means to pay costs of incarceration. RCW 9.94A.760. [ ] (Name of agency) ___________________________ ‘s costs for its emergency response are reasonble. RCW 38.52.430 (effective August 1, 2012). III. Judgment 3.1 The defendant is guilty of the Counts and Charges listed in Paragraph 2.1 and Appendix 2.1. 3.2 [ ] The court dismisses Counts the charging document. in IV. Sentence and Order It is ordered: 4.1 Confinement. The court sentences the defendant to total confinement as follows: (a) Confinement. RCW 9.94A.589. A term of total confinement in the custody of the Department of Corrections (DOC): months on Count months on Count months on Count months on Count months on Count months on Count [ ] The confinement time on Count(s)___________ contain(s) a mandatory minimum term of __________. [ ] The confinement time on Count __________________________ includes _____________ months as enhancement for [ ] firearm [ ] deadly weapon [ ] VUCSA in a protected zone [ ] manufacture of methamphetamine with juvenile present. Actual number of months of total confinement ordered is:_____________________________________. All counts shall be served concurrently, except for the portion of those counts for which there is an enhancement as set forth above at Section 2.3, and except for the following counts which shall be served consecutively:______________________________________________________________________. This sentence shall run consecutively with the sentence in the following cause number(s) (see RCW 9.94A.589(3)): ________________________________________________________________. Confinement shall commence immediately unless otherwise set forth here:__________________________ _________________________________________________________________________________. (b) Credit for Time Served. The defendant shall receive credit for time served prior to sentencing if that confinement was solely under this cause number. RCW 9.94A.505. The jail shall compute time served. Felony Judgment and Sentence (FJS) (Prison)(Nonsex Offender) (RCW 9.94A.500, .505)(WPF CR 84.0400 (06/2012)) Page 4 of 10 American LegalNet, Inc. www.FormsWorkFlow.com (c) [ ] Work Ethic Program. RCW 9.94A.690, RCW 72.09.410. The court finds that the defendant is eligible and is likely to qualify for work ethic program. The court recommends that the defendant serve the sentence at a work ethic program. Upon completion of work ethic program, the defendant shall be released on community custody for any remaining time of total confinement, subject to the conditions in Section 4.2. Violation of the conditions of community custody may result in a return to total confinement for the balance of the defendant’s remaining time of confinement. 4.2 Community Custody. (To determine which offenses are eligible for or required for community custody see RCW 9.94A.701) (A) The defendant shall be on community custody for the longer of: (1) the period of early release. RCW 9.94A.728(1)(2); or (2) the period imposed by the court, as follows: Count(s) _____________ 36 months for Serious Violent Offenses Count(s) _____________ 18 months for Violent Offenses Count(s) _____________ 12 months (for crimes against a person, drug offenses, or offenses involving the unlawful possession of a firearm by a street gang member or associate) Note: combined term of confinement and community custody for any particular offense cannot exceed the statutory maximum. RCW 9.94A.701. (B) While on community custody, the defendant shall: (1) report to and be available for contact with the assigned community corrections officer as directed; (2) work at DOC-approved education, employment and/or community restitution (service); (3) notify DOC of any change in defendant’s address or employment; (4) not consume controlled substances except pursuant to lawfully issued prescriptions; (5) not unlawfully possess controlled substances while on community custody; (6) not own, use, or possess firearms or ammunition; (7) pay supervision fees as determined by DOC; (8) perform affirmative acts as required by DOC to confirm compliance with the orders of the court; and (9) abide by any additional conditions imposed by DOC under RCW 9.94A.704 and .706. The defendant’s residence location and living arrangements are subject to the prior approval of DOC while on community custody. The court orders that during the period of supervision the defendant shall: [ ] consume no alcohol. [ ] have no contact with: ___________________________________________. [ ] remain [ ] within [ ] outside of a specified geographical boundary, to wit: _________________________________________________________________________________. [ ] not serve in any paid or volunteer capacity where he or she has control or supervision of minors under 13 years of age. [ ] participate in the following crime-related treatment or counseling services: _________________________________________________________________________________. [ ] undergo an evaluation for treatment for [ ] domestic violence [ ] substance abuse [ ] mental health [ ] anger management, and fully comply with all recommended treatment. [ ] comply with the following crime-related prohibitions:________________________________________ __________________________________________________________________________________ _________________________________________________________________________________. [ ] Other conditions: __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ _________________________________________________________________________________. Felony Judgment and Sentence (FJS) (Prison)(Nonsex Offender) (RCW 9.94A.500, .505)(WPF CR 84.0400 (06/2012)) Page 5 of 10 American LegalNet, Inc. www.FormsWorkFlow.com Court Ordered Treatment: If any court orders mental health or chemical dependency treatment, the defendant must notify DOC and the defendant must release treatment information to DOC for the duration of incarceration and supervision. RCW 9.94A.562. 4.3 Legal Financial Obligations: The defendant shall pay to the clerk of this court: JASS CODE PCV $ PDV $_____________Domestic Violence assessment CRC $ Court costs, including RCW 9.94A.760, 9.94A.505, 10.01.160, 10.46.190 PUB $ Criminal filing fee $ Witness costs $ Sheriff service fees $ Jury demand fee $ Extradition costs $ Other $ Fees for court appointed attorney WFR $ Court appointed defense expert and other defense costs FCM/MTH $ Fine RCW 9A.20.021; [ ] VUCSA chapter 69.50 RCW, [ ] VUCSA additional fine deferred due to indigency RCW 69.50.430 CDF/LDI/FCD NTF/SAD/SDI $ Drug enforcement fund of ____________________ 500 Victim assessment RCW 7.68.035 RCW 10.99.080 FRC WFR SFR/SFS/SFW/WRF JFR EXT RCW 9.94A.760 RCW 9.94A.760 RCW 9.94A.760 $____________ DUI fines, fees and assessments Crime lab fee [ ] suspended due to indigency RCW 43.43.690 DNA collection fee RCW 43.43.7541 $ Specialized forest products RCW 76.48.140 $ Other fines or costs for: $ CLF Emergency response costs ($1000 maximum, $2,500 max. effective $ $ FPV DEF 100 Aug. 1, 2012.) RCW 38.52.430 Agency: $ Restitution to: $ Restitution to: $ Restitution to: RTN/RJN $ Total (Name and Address--address may be withheld and provided confidentially to Clerk of the Court’s office.) RCW 9.94A.760 [ ] The above total does not include all restitution or other legal financial obligations, which may be set by later order of the court. An agreed restitution order may be entered. RCW 9.94A.753. A restitution hearing: [ ] shall be set by the prosecutor. (date). [ ] is scheduled for [ ] The defendant waives any right to be present at any restitution hearing (sign initials):_____________. [ ] Restitution Schedule attached. Felony Judgment and Sentence (FJS) (Prison)(Nonsex Offender) (RCW 9.94A.500, .505)(WPF CR 84.0400 (06/2012)) Page 6 of 10 American LegalNet, Inc. www.FormsWorkFlow.com RJN [ ] Restitution ordered above shall be paid jointly and severally with: Name of other defendant Cause Number (Victim’s name) (Amount-$) ____________________________________________________________________________________ ____________________________________________________________________________________ [ ] The Department of Corrections (DOC) or clerk of the court shall immediately issue a Notice of Payroll Deduction. RCW 9.94A.7602, RCW 9.94A.760(8). [ ] All payments shall be made in accordance with the policies of the clerk of the court and on a schedule established by DOC or the clerk of the court, commencing immediately, unless the court specifically sets forth the rate here: Not less than $________ per month commencing_______________________________. RCW 9.94A.760. The defendant shall report to the clerk of the court or as directed by the clerk of the court to provide financial and other information as requested. RCW 9.94A.760(7)(b). [ ] The court orders the defendant to pay costs of incarceration at the rate of $_____________ per day, (actual costs not to exceed $100 per day). (JLR) RCW 9.94A.760. (This provision does not apply to costs of incarceration collected by DOC under RCW 72.09.111 and 72.09.480.) The financial obligations imposed in this judgment shall bear interest from the date of the judgment until payment in full, at the rate applicable to civil judgments. RCW 10.82.090. An award of costs on appeal against the defendant may be added to the total legal financial obligations. RCW 10.73.160. 4.4 DNA Testing. The defendant shall have a biological sample collected for purposes of DNA identification analysis and the defendant shall fully cooperate in the testing. The appropriate agency shall be responsible for obtaining the sample prior to the defendant's release from confinement. This paragraph does not apply if it is established that the Washington State Patrol crime laboratory already has a sample from the defendant for a qualifying offense. RCW 43.43.754. [ ] HIV Testing. The defendant shall submit to HIV testing. RCW 70.24.340. 4.5 No Contact: [ ] The defendant shall not have contact with ______________________________________________ __________________________________________________________ (name) including, but not limited to, personal, verbal, telephonic, written or contact through a third party until __________________ (which does not exceed the maximum statutory sentence). [ ] The defendant is excluded or prohibited from coming within _______________________(distance) of: [ ] __________ _____________________________________(name of protected person(s))’s [ ] home/ residence [ ] work place [ ] school [ ] (other location(s)) ______________________________________ _______________________________________________________________________________, or [ ] other location: __________________________________________________________________, until __________________________________ (which does not exceed the maximum statutory sentence). [ ] A separate Domestic Violence No-Contact Order or Antiharassment No-Contact Order is filed concurrent with this Judgment and Sentence. 4.6 Other: 4.7 Off-Limits Order. (Known drug trafficker). RCW 10.66.020. The following areas are off limits to the defendant while under the supervision of the county jail or Department of Corrections: _______________ Felony Judgment and Sentence (FJS) (Prison)(Nonsex Offender) (RCW 9.94A.500, .505)(WPF CR 84.0400 (06/2012)) Page 7 of 10 American LegalNet, Inc. www.FormsWorkFlow.com ____________________________________________________________________________________. V. Notices and Signatures 5.1 Collateral Attack on Judgment. If you wish to petition or move for collateral attack on this Judgment and Sentence, including but not limited to any personal restraint petition, state habeas corpus petition, motion to vacate judgment, motion to withdraw guilty plea, motion for new trial or motion to arrest judgment, you must do so within one year of the final judgment in this matter, except as provided for in RCW 10.73.100. RCW 10.73.090. 5.2 Length of Supervision. If you committed your offense prior to July 1, 2000, you shall remain under the court's jurisdiction and the supervision of the Department of Corrections for a period up to 10 years from the date of sentence or release from confinement, whichever is longer, to assure payment of all legal financial obligations unless the court extends the criminal judgment an additional 10 years. If you committed your offense on or after July 1, 2000, the court shall retain jurisdiction over you, for the purpose of your compliance with payment of the legal financial obligations, until you have completely satisfied your obligation, regardless of the statutory maximum for the crime. RCW 9.94A.760 and RCW 9.94A.505(5). The clerk of the court has authority to collect unpaid legal financial obligations at any time while you remain under the jurisdiction of the court for purposes of your legal financial obligations. RCW 9.94A.760(4) and RCW 9.94A.753(4). 5.3 Notice of Income-Withholding Action. If the court has not ordered an immediate notice of payroll deduction in Section 4.1, you are notified that the Department of Corrections (DOC) or the clerk of the court may issue a notice of payroll deduction without notice to you if you are more than 30 days past due in monthly payments in an amount equal to or greater than the amount payable for one month. RCW 9.94A.7602. Other income-withholding action under RCW 9.94A.760 may be taken without further notice. RCW 9.94A.7606. 5.4 Community Custody Violation. (a) If you are subject to a first or second violation hearing and DOC finds that you committed the violation, you may receive as a sanction up to 60 days of confinement per violation. RCW 9.94A.633. (b) If you have not completed your maximum term of total confinement and you are subject to a third violation hearing and DOC finds that you committed the violation, DOC may return you to a state correctional facility to serve up to the remaining portion of your sentence. RCW 9.94A.714. 5.5 Firearms. You may not own, use or possess any firearm, and under federal law any firearm or ammunition, unless your right to do so is restored by the court in which you are convicted or the superior court in Washington State where you live, and by a federal court if required. You must immediately surrender any concealed pistol license. (The clerk of the court shall forward a copy of the defendant's driver's license, identicard, or comparable identification to the Department of Licensing along with the date of conviction or commitment.) RCW 9.41.040, 9.41.047. 5.6 Reserved 5.7 Motor Vehicle: If the court found that you used a motor vehicle in the commission of the offense, then the Department of Licensing will revoke your driver’s license. The clerk of the court is directed to immediately forward an Abstract of Court Record to the Department of Licensing, which must revoke your driver’s license. RCW 46.20.285. 5.8 Other: ____________________________________________________________________________. Done in Open Court and in the presence of the defendant this date:______________________________. _______________________________________________ Judge/Print Name: _____________________________ Deputy Prosecuting Attorney WSBA No. Print Name: ____________________________ Attorney for Defendant WSBA No. Print Name: Felony Judgment and Sentence (FJS) (Prison)(Nonsex Offender) (RCW 9.94A.500, .505)(WPF CR 84.0400 (06/2012)) _____________________________ Defendant Print Name: Page 8 of 10 American LegalNet, Inc. www.FormsWorkFlow.com Voting Rights Statement: I acknowledge that I have lost my right to vote because of this felony conviction. If I am registered to vote, my voter registration will be cancelled. My right to vote is provisionally restored as long as I am not under the authority of DOC (not serving a sentence of confinement in the custody of DOC and not subject to community custody as defined in RCW 9.94A.030). I must reregister before voting. The provisional right to vote may be revoked if I fail to comply with all the terms of my legal financial obligations or an agreement for the payment of legal financial obligations My right to vote may be permanently restored by one of the following for each felony conviction: a) a certificate of discharge issued by the sentencing court, RCW 9.94A.637; b) a court order issued by the sentencing court restoring the right, RCW 9.92.066; c) a final order of discharge issued by the indeterminate sentence review board, RCW 9.96.050; or d) a certificate of restoration issued by the governor, RCW 9.96.020. Voting before the right is restored is a class C felony, RCW 29A.84.660. Registering to vote before the right is restored is a class C felony, RCW 29A.84.140. Defendant’s signature: ______________________________________________ I am a certified or registered interpreter, or the court has found me otherwise qualified to interpret, in the _________________________________ language, which the defendant understands. I interpreted this Judgment and Sentence for the defendant into that language. I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Signed at (city) ____________________, (state) _______________, on (date) ______________________. _______________________________________ Interpreter ____________________________________________ Print Name Felony Judgment and Sentence (FJS) (Prison)(Nonsex Offender) (RCW 9.94A.500, .505)(WPF CR 84.0400 (06/2012)) Page 9 of 10 American LegalNet, Inc. www.FormsWorkFlow.com VI. Identification of the Defendant SID No. ______________________________________ (If no SID complete a separate Applicant card (form FD-258) for State Patrol) Date of Birth _____________________________ FBI No. ______________________________________ Local ID No. _____________________________ PCN No. _____________________________________ Other ___________________________________ Alias name, DOB: _______________________________________________________________________ Race: Ethnicity: [ ] Hispanic [ ] Asian/Pacific Islander [ ] Black/AfricanAmerican [ ] Caucasian [ ] Native American [ ] Other:________________________________ Sex: [ ] Male [ ] Non-Hispanic [ ] Female Fingerprints: I attest that I saw the defendant who appeared in court affix his or her fingerprints and signature on this document. Clerk of the Court, Deputy Clerk, __________________________________ Dated:_____________________ The defendant’s signature: Left four fingers taken simultaneously Left Thumb Right Thumb Felony Judgment and Sentence (FJS) (Prison)(Nonsex Offender) (RCW 9.94A.500, .505)(WPF CR 84.0400 (06/2012)) Right four fingers taken simultaneously Page 10 of 10 American LegalNet, Inc. www.FormsWorkFlow.com