Form JD-CR-105 "Request by Victim of Sexual Act to Test Defendant for Aids/Hiv" - Connecticut

What Is Form JD-CR-105?

This is a legal form that was released by the Connecticut Superior Court - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2006;
  • The latest edition provided by the Connecticut Superior Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form JD-CR-105 by clicking the link below or browse more documents and templates provided by the Connecticut Superior Court.

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Download Form JD-CR-105 "Request by Victim of Sexual Act to Test Defendant for Aids/Hiv" - Connecticut

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REQUEST BY VICTIM OF
STATE OF CONNECTICUT
SEXUAL ACT TO TEST
SUPERIOR COURT
DEFENDANT FOR AIDS/HIV
www.jud.ct.gov
JD-CR-105 Rev. 10-06
C.G.S. §§ 19a-581 to 19a-585, 54-102a, 54-102b
INSTRUCTIONS TO VICTIM: Forward completed original and three copies to the clerk of court. Retain a copy for your records.
INSTRUCTIONS TO CLERK: Pursuant to C.G.S. § 54-86e, the name and address of the victims of sexual assaults, or attempts, are confidential and
only disclosable on order of the court, except it is available to the accused. Place in a sealed envelope and maintain with the court file. Send one copy
to the State's Attorney and one copy to the defendant's attorney.
TO: The Superior Court of the State of Connecticut
JUDICIAL DISTRICT OR G.A. NO.
ADDRESS OF COURT (No., street, town and zip code)
DOCKET NO.
NAME OF DEFENDANT
CRIME(S) CHARGED AGAINST DEFENDANT
NAME OF VICTIM
ADDRESS TO WHICH NOTICE TO VICTIM IS TO BE SENT
REQUEST THAT THE DEFENDANT BE TESTED FOR AIDS/HIV
I, the undersigned victim, hereby make the following statements and request:
1. The above-named defendant is accused of a violation of section 53a-70 (sexual assault, 1st degree), 53a-70a
(aggravated sexual assault, 1st degree), 53a-70b (sexual assault in a spousal or cohabiting relationship) or 53a-71
(sexual assault, 2nd degree) of the general statutes or a violation of section 53-21 (injury or risk of injury to a child),
53a-72a (sexual assault, 3rd degree), 53a-72b (sexual assault, 3rd degree with a firearm), or 53a-73a (sexual assault,
4th degree) of the general statutes involving a sexual act, as that term is defined in general statutes section 54-102b.
2. I am the victim of such crime.
3. I hereby request that above-named defendant be tested: ("X" one or both)
AS SOON AS POSSIBLE
UPON THE COURT ENTERING A JUDGMENT OF CONVICTION
for the presence of the etiologic agent for acquired immune deficiency syndrome (AIDS) or human immunodeficiency
virus (HIV) and that the results be disclosed to me.
SIGNED (Victim/Consented to by Parent or Guardian of minor Victim/Attorney for Victim)
DATE SIGNED
I have read the above and understand it.
I agree to the foregoing statements.
ORDER OF THE COURT
It is hereby ORDERED by the court:
Request DENIED.
Request GRANTED.
(C.G.S. § 54-102b requires granting request if the defendant is convicted or adjudicated delinquent.)
If the defendant is incarcerated, convicted or adjudicated delinquent, the Commissioner of Correction is hereby ordered to
have the above-named defendant tested for the presence of the etiologic agent for acquired immune deficiency syndrome or
human immunodeficiency virus. Said test shall be performed by or at the direction of the Department of Correction in
consultation with the Department of Public Health. The provisions of sections 19a-581 to 19a-585, inclusive, and section
19a-590 of the general statutes, except the requirement that the subject of an HIV-related test provide informed consent prior
to the performance of such test and except any provision that would prohibit or limit disclosure of the results of such test to
the victim, the court or the Department of Public Health if so ordered below, shall apply to the test ordered and the disclosure
of the results of such test.
If the defendant is not incarcerated, convicted or adjudicated delinquent, the defendant shall forthwith select a Department
of Public Health testing site from a list provided by the clerk of the court and the testing site is hereby ordered to have the
above-named defendant tested for the presence of the etiologic agent for acquired immune deficiency syndrome or human
immunodeficiency virus. The provisions of sections 19a-581 to 19a-585, inclusive, and section 19a-590 of the general
statutes, except the requirement that the subject of an HIV-related test provide informed consent prior to the performance of
such test and except any provision that would prohibit or limit disclosure of the results of such test to the victim, the court or
the Department of Public Health if so ordered below, shall apply to the test ordered and the disclosure of the results of such
test.
The results of such test
SHALL
SHALL NOT
be disclosed to the victim.
(C.G.S. § 54-102b requires disclosure of results to the victim if the defendant was convicted or adjudicated delinquent.
C.G.S. § 54-102a makes disclosure discretionary with the court if the defendant is accused but not convicted or adjudicated delinquent.)
A report of the results of such test shall be filed with the Department of Public Health, on a form supplied by it, and filed
with this court. ("X" only if the defendant is accused but not convicted or adjudicated delinquent.)
BY ORDER OF THE COURT (Print or type name of judge)
SIGNED (Judge)
DATE SIGNED
PRINT
RESET
REQUEST BY VICTIM OF
STATE OF CONNECTICUT
SEXUAL ACT TO TEST
SUPERIOR COURT
DEFENDANT FOR AIDS/HIV
www.jud.ct.gov
JD-CR-105 Rev. 10-06
C.G.S. §§ 19a-581 to 19a-585, 54-102a, 54-102b
INSTRUCTIONS TO VICTIM: Forward completed original and three copies to the clerk of court. Retain a copy for your records.
INSTRUCTIONS TO CLERK: Pursuant to C.G.S. § 54-86e, the name and address of the victims of sexual assaults, or attempts, are confidential and
only disclosable on order of the court, except it is available to the accused. Place in a sealed envelope and maintain with the court file. Send one copy
to the State's Attorney and one copy to the defendant's attorney.
TO: The Superior Court of the State of Connecticut
JUDICIAL DISTRICT OR G.A. NO.
ADDRESS OF COURT (No., street, town and zip code)
DOCKET NO.
NAME OF DEFENDANT
CRIME(S) CHARGED AGAINST DEFENDANT
NAME OF VICTIM
ADDRESS TO WHICH NOTICE TO VICTIM IS TO BE SENT
REQUEST THAT THE DEFENDANT BE TESTED FOR AIDS/HIV
I, the undersigned victim, hereby make the following statements and request:
1. The above-named defendant is accused of a violation of section 53a-70 (sexual assault, 1st degree), 53a-70a
(aggravated sexual assault, 1st degree), 53a-70b (sexual assault in a spousal or cohabiting relationship) or 53a-71
(sexual assault, 2nd degree) of the general statutes or a violation of section 53-21 (injury or risk of injury to a child),
53a-72a (sexual assault, 3rd degree), 53a-72b (sexual assault, 3rd degree with a firearm), or 53a-73a (sexual assault,
4th degree) of the general statutes involving a sexual act, as that term is defined in general statutes section 54-102b.
2. I am the victim of such crime.
3. I hereby request that above-named defendant be tested: ("X" one or both)
AS SOON AS POSSIBLE
UPON THE COURT ENTERING A JUDGMENT OF CONVICTION
for the presence of the etiologic agent for acquired immune deficiency syndrome (AIDS) or human immunodeficiency
virus (HIV) and that the results be disclosed to me.
SIGNED (Victim/Consented to by Parent or Guardian of minor Victim/Attorney for Victim)
DATE SIGNED
I have read the above and understand it.
I agree to the foregoing statements.
ORDER OF THE COURT
It is hereby ORDERED by the court:
Request DENIED.
Request GRANTED.
(C.G.S. § 54-102b requires granting request if the defendant is convicted or adjudicated delinquent.)
If the defendant is incarcerated, convicted or adjudicated delinquent, the Commissioner of Correction is hereby ordered to
have the above-named defendant tested for the presence of the etiologic agent for acquired immune deficiency syndrome or
human immunodeficiency virus. Said test shall be performed by or at the direction of the Department of Correction in
consultation with the Department of Public Health. The provisions of sections 19a-581 to 19a-585, inclusive, and section
19a-590 of the general statutes, except the requirement that the subject of an HIV-related test provide informed consent prior
to the performance of such test and except any provision that would prohibit or limit disclosure of the results of such test to
the victim, the court or the Department of Public Health if so ordered below, shall apply to the test ordered and the disclosure
of the results of such test.
If the defendant is not incarcerated, convicted or adjudicated delinquent, the defendant shall forthwith select a Department
of Public Health testing site from a list provided by the clerk of the court and the testing site is hereby ordered to have the
above-named defendant tested for the presence of the etiologic agent for acquired immune deficiency syndrome or human
immunodeficiency virus. The provisions of sections 19a-581 to 19a-585, inclusive, and section 19a-590 of the general
statutes, except the requirement that the subject of an HIV-related test provide informed consent prior to the performance of
such test and except any provision that would prohibit or limit disclosure of the results of such test to the victim, the court or
the Department of Public Health if so ordered below, shall apply to the test ordered and the disclosure of the results of such
test.
The results of such test
SHALL
SHALL NOT
be disclosed to the victim.
(C.G.S. § 54-102b requires disclosure of results to the victim if the defendant was convicted or adjudicated delinquent.
C.G.S. § 54-102a makes disclosure discretionary with the court if the defendant is accused but not convicted or adjudicated delinquent.)
A report of the results of such test shall be filed with the Department of Public Health, on a form supplied by it, and filed
with this court. ("X" only if the defendant is accused but not convicted or adjudicated delinquent.)
BY ORDER OF THE COURT (Print or type name of judge)
SIGNED (Judge)
DATE SIGNED
PRINT
RESET