As a victim of a crime, you may have suffered medical, psychological and/or financial losses. The form below is called a Victim Impact Statement. This form documents the expenses a victim has incurred due to a crime and the victim’s wishes regarding sentence imposed on the defendant. This form, with its supporting documentation (receipts, estimates, proof of deductible, etc.), is an important part of the decision-making process for the District Attorney’s Office and the Court. It is also included in the Pre-Sentence Report from the Probation Department, which is given to the District Attorney and the Defense, and is used by the Court to help determine sentencing and restitution, if any. Please complete this form and return it and your supporting documentation to the District Attorney’s Office as soon as possible so that it is available for consideration in your case.