Form NPP JSF014 "Victim Impact Form - Adult" - Nevada

What Is Form NPP JSF014?

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

Form Details:

  • Released on October 3, 2019;
  • The latest edition provided by the Nevada Department of Public Safety;
  • 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 NPP JSF014 by clicking the link below or browse more documents and templates provided by the Nevada Department of Public Safety.

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Download Form NPP JSF014 "Victim Impact Form - Adult" - Nevada

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Division of Parole and Probation
Victim Impact Notice
October 8, 2019
Victim name:
RE: Defendant Name:
Address:
Case No.:
City, State, Zip:
Incident Date:
The Division of Parole and Probation is conducting a pre-sentence investigation on the above-named defendant. It is our
understanding that you were the victim of this crime. As part of our investigation, we attempt to determine: (1) What loss
or expenses you suffered as a result of this crime; and (2) How you were affected by the crime itself.
Per Nevada Revised Statute, the sentencing court shall order the offender to pay restitution to you if you suffered a
monetary loss as a result of their crime. The Division would request that you return the attached questionnaire
immediately, and provide documentation verifying your loss, if available, for consideration of restitution.
If we do not receive the completed questionnaire back from you, we will assume that no loss has been incurred or you are
not interested in receiving restitution. If no financial loss was suffered, we would still like you to express your feelings
regarding the defendant and how this crime has affected you.
NRS 176.015 §3
requires the court allow a victim to be heard prior to sentencing, opinions on the crime, perpetrator, the
offense impact or need for restitution may be expressed. If you wish to address the court, you must contact the District
(7XX) XXX-XXXX
Attorney’s Office,
, to arrange for your appearance.
The State of Nevada and the Division of Parole and Probation has included a free anonymous and confidential resource
link available to the victim(s) 24 hours a day by phone or via internet to help the victim (s) be notified when the
defendant has been released, transferred, escaped or has a court date/appearance. To register call toll free 1-888-268-8463.
The services are available via the internet at
www.vinelink.com
and then follow the instructions to register.
As a victim you are entitled to certain rights which are outlined in Marsy’s Law Declaration of Rights. They can be
accessed at the Division of Parole and Probation website
Victims' Bill of Rights
(http://npp.dps.nv.gov/Home/Resources/
Victim_s_BOR) page.
The State of Nevada has funds available to qualifying victims for compensation for injury, loss or counseling. For
additional information, contact the District Attorney’s Office.
Please mail your completed questionnaire to:
Nevada Division of Parole and Probation
or fax to
(7XX) XXX-XXXX
or email to:
XXXXXX@dps.state.nv.us
Should you have any questions, please contact the undersigned at
(7XX) XXX-XXXX
. Thank you for your cooperation in
this matter.
XXXXXXXX, Specialist XX
(7XX) XXX-XXXX
XXXXXXXX@dps.state.nv.us
NPP Specialist
Page 1 of 3
NPP JSF014 (A) Victim Impact Form - Aduilt
10/03/2019
Division of Parole and Probation
Victim Impact Notice
October 8, 2019
Victim name:
RE: Defendant Name:
Address:
Case No.:
City, State, Zip:
Incident Date:
The Division of Parole and Probation is conducting a pre-sentence investigation on the above-named defendant. It is our
understanding that you were the victim of this crime. As part of our investigation, we attempt to determine: (1) What loss
or expenses you suffered as a result of this crime; and (2) How you were affected by the crime itself.
Per Nevada Revised Statute, the sentencing court shall order the offender to pay restitution to you if you suffered a
monetary loss as a result of their crime. The Division would request that you return the attached questionnaire
immediately, and provide documentation verifying your loss, if available, for consideration of restitution.
If we do not receive the completed questionnaire back from you, we will assume that no loss has been incurred or you are
not interested in receiving restitution. If no financial loss was suffered, we would still like you to express your feelings
regarding the defendant and how this crime has affected you.
NRS 176.015 §3
requires the court allow a victim to be heard prior to sentencing, opinions on the crime, perpetrator, the
offense impact or need for restitution may be expressed. If you wish to address the court, you must contact the District
(7XX) XXX-XXXX
Attorney’s Office,
, to arrange for your appearance.
The State of Nevada and the Division of Parole and Probation has included a free anonymous and confidential resource
link available to the victim(s) 24 hours a day by phone or via internet to help the victim (s) be notified when the
defendant has been released, transferred, escaped or has a court date/appearance. To register call toll free 1-888-268-8463.
The services are available via the internet at
www.vinelink.com
and then follow the instructions to register.
As a victim you are entitled to certain rights which are outlined in Marsy’s Law Declaration of Rights. They can be
accessed at the Division of Parole and Probation website
Victims' Bill of Rights
(http://npp.dps.nv.gov/Home/Resources/
Victim_s_BOR) page.
The State of Nevada has funds available to qualifying victims for compensation for injury, loss or counseling. For
additional information, contact the District Attorney’s Office.
Please mail your completed questionnaire to:
Nevada Division of Parole and Probation
or fax to
(7XX) XXX-XXXX
or email to:
XXXXXX@dps.state.nv.us
Should you have any questions, please contact the undersigned at
(7XX) XXX-XXXX
. Thank you for your cooperation in
this matter.
XXXXXXXX, Specialist XX
(7XX) XXX-XXXX
XXXXXXXX@dps.state.nv.us
NPP Specialist
Page 1 of 3
NPP JSF014 (A) Victim Impact Form - Aduilt
10/03/2019
Victim Impact Statement
Case #:
DATE:
Return to:
Specialist NAME
OFFENDER:
CC#:
VICTIM (BUSINESS/INDIVIDUAL):
SOCIAL SECURITY #
TAX ID #
MAILING ADDRESS:
CITY
STATE
ZIP CODE
HOME TELEPHONE:
WORK TELEPHONE:
A. INSURANCE CLAIM SUBMITTED?
YES
NO
COMPANY
ADDRESS
CITY/STATE/ZIP CODE
TELEPHONE:
CLAIM #
POLICY #
DEDUCTIBLE:
CLAIM AMOUNT:
SETTLEMENT:
(Not to include lost wages)
TOTAL OUT-OF POCKET LOSS:
AMOUNT
B. Have you applied for or received County compensation?
YES
NO
Have you applied for or received State compensation?
AMOUNT
YES
NO
C. Do you intend to address the Court in person?
NO
YES
IMPORTANT: NRS 176A.630 and NRS 209.392, allow a victim the ability to “opt in” for future offender notification(s) by the
Division; specifically, instances when an offender is being returned to Court by the Division for modification of their underlying
sentence and when imprisoned, and notification if an offender has been approved for a Residential Confinement (House Arrest)
program by the Division. The Nevada Department of Corrections (NDOC) is responsible for additional notification if an offender is
in their custody. You can sign up for NDOC notification on their web-site
NDOC Notifications
(http://doc.nv.gov/Victims/
Victims_Notifications)
I would like to “opt in” for future P&P offender notification:
YES
NO
* If you move, please provide your new address by calling the Division at (775) 684-2614.
Page 2 of 3
NPP JSF014 (A) Victim Impact Form - Aduilt
10/03/2019
Victim Impact Statement
Case #:
Return to: Specialist NAME
PLEASE DESCRIBE HOW YOU WERE IMPACTED BY THIS CRIME. Note extent of injuries, property
damage or loss, physical disabilities, funeral expenses or psychological/adjustment problems. Attach
documentation (i.e. estimates, insurance claims, medical bills, etc.). You may use the back of this page or
attach additional pages for your comments:
Signature
Print Name
Page 3 of 3
NPP JSF014 (A) Victim Impact Form - Aduilt
10/03/2019
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