Form NPP JSF015 "Victim Impact Form - Child" - Nevada

What Is Form NPP JSF015?

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 9, 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 JSF015 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 JSF015 "Victim Impact Form - Child" - Nevada

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Division of Parole and Probation
Victim Impact Notice
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 and/or your child are a 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.
Information obtained during the investigation is the basis for a report that will assist the Judge for the purpose of
sentencing.
The sentencing court must order the offender to pay restitution to you if you suffered a monetary loss as a result of their
crime. The Division is requesting you return the attached questionnaire as soon as possible, and provide documentation
verifying your loss, if available, for consideration of restitution. If your child has suffered a financial loss as a result of
this crime, restitution can be ordered for damage or loss of property, and medical, psychological or dental treatment if
related to the defendant's criminal conduct.
If restitution is not an issue, a Victim Impact Statement explaining how the crime has affected you and your immediate
family is still requested. A separate statement is also provided so that your child can offer his/her thoughts as well.
NRS
176.015 §3
requires the court allow a victim , or their representative, 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 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 return your completed Victim Questionnaire and
Victim Impact Statement(s) within 10 days. The Division is aware that navigating the criminal justice system can be a
confusing, frustrating process, and appreciates your assistance.
Please mail your completed questionnaire to:
Nevada Division of Parole and Probation
or fax to
or email to:
Should you have any questions, please contact the undersigned at
. Thank you for your cooperation in
this matter.
NPP Specialist
Page 1 of 4
NPP JSF015 (A) Victim Impact Child PSI
10/09/2019
Division of Parole and Probation
Victim Impact Notice
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 and/or your child are a 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.
Information obtained during the investigation is the basis for a report that will assist the Judge for the purpose of
sentencing.
The sentencing court must order the offender to pay restitution to you if you suffered a monetary loss as a result of their
crime. The Division is requesting you return the attached questionnaire as soon as possible, and provide documentation
verifying your loss, if available, for consideration of restitution. If your child has suffered a financial loss as a result of
this crime, restitution can be ordered for damage or loss of property, and medical, psychological or dental treatment if
related to the defendant's criminal conduct.
If restitution is not an issue, a Victim Impact Statement explaining how the crime has affected you and your immediate
family is still requested. A separate statement is also provided so that your child can offer his/her thoughts as well.
NRS
176.015 §3
requires the court allow a victim , or their representative, 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 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 return your completed Victim Questionnaire and
Victim Impact Statement(s) within 10 days. The Division is aware that navigating the criminal justice system can be a
confusing, frustrating process, and appreciates your assistance.
Please mail your completed questionnaire to:
Nevada Division of Parole and Probation
or fax to
or email to:
Should you have any questions, please contact the undersigned at
. Thank you for your cooperation in
this matter.
NPP Specialist
Page 1 of 4
NPP JSF015 (A) Victim Impact Child PSI
10/09/2019
VICTIM IMPACT STATEMENT
School Aged Children
Case #:
Return to:
Date:
Defendant:
CC#:
Victim (Business or Individual ):
Social Security No.:
Tax ID No.:
Mailing Address:
City:
State:
Zip Code:
Home Telephone:
Work Telephone:
Insurance Claim Submitted?
YES
NO
Company:
Address:
City/State/Zip Code:
Telephone:
Claim No.:
Deductible:
Policy No.:
Claim Amount:
Total Out-of-Pocket Loss*:
Settlement:
(*Do NOT include lost wages)
Have you applied for or received County compensation?
Yes
No
AMOUNT
Have you applied for or received State compensation?
AMOUNT
Yes
No
Do you intend to address the Court in person?
Yes
No
IMPORTANT: NRS 176A.630 and NRS 209.392, allow a victim the ability to “opt in” for future offender notification(s) from 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 (refer to NPP JSF016 Victim Locator form,) by calling
the Division at (775) 684-2600 or using the Victim Address Change form here:
NPP
Resources.
Page 2 of 4
NPP JSF015 (A) Victim Impact Child PSI
10/09/2019
Division of Parole and Probation
Victim Impact for Parents of Child Victims
Parent or Guardian name:
Child's name:
Name of defendant
Has your child been emotionally affected by this crime? If yes, you may wish to discuss how the crime may have affected
your child's relationships with you, family members, and those close to you. If your child received any form of victim
services such as counseling by either a licensed professional, member of the clergy or a community-support group, you
may wish to mention this. Please use additional paper as necessary.
Was your child physically injured or hurt as a result of this crime? If yes, you may wish to write about the type of
injuries your child had, what medical treatment your child received, and how long these injuries lasted or are expected to
last. Please use additional paper as necessary.
Has this crime affected the way your child relates to his or her friends, either at school or in your neighborhood? Has this
crime affected your child's school work in any way? Please use additional paper as necessary.
How has this crime affected you, your family and those close to your child? You may wish to write about changes that
may have occurred in your family, in your ability to perform your work, make a living, run a household or enjoy any
other activities you enjoyed before the crime. You may also wish to include any victim services or counseling that you
and those close to your child have received. Please use additional paper as necessary.
If your child is just learning to read, help your child fill out the victim impact statement. When helping your child, read
the directions aloud to your child, talk about what feelings are (happy, sad, mad, scared, or any other feelings you think
are appropriate), and what your child may want to think about when they are drawing or writing on the statement. Please
do not tell your child what to draw or write. This is your child's chance to tell the judge how he or she is feeling about
what has happened. If your child would rather draw a picture of a bird, a boat, or write a story about bumblebees, this is
okay. Should your child become uncomfortable in any way while filling out the victim impact statement, reassure your
child that he or she does not have to fill out the form unless he or she wants to.
Page 3 of 4
NPP JSF015 (A) Victim Impact Child PSI
10/09/2019
Division of Parole and Probation
for Children
What is your name?
Do you got to school?
Yes
No
If yes, what grade are you in?
You may write a short answer and/or circle as many below as you wish
How do you feel about what happened?
Happy
Sad
Mad
Scared
Other
Please write or draw anything you would like the judge to know about how you feel because of what has happened. You
may want to write about anything that has changed in your life or in your family. You can even tell a story or write a
poem if you would like. You can add more paper if you run out of room.
Please write or draw anything you want the judge to know that may be different at school, in your neighborhood or with
your friends because of what has happened. You can add more paper if you run out of room.
If you were the judge, what would you do to the person who hurt you?
Send him to jail
Order him to pay money to fix what he did
Order him to go to a doctor to get help
Nothing
Make him/her stay away from kids
Put your own idea here:
NPP JSF015 (A) Impact Form PSI
10/09/2019
Page of 4