Victim Impact Statement for Family or Friends of a Homicide Victim

As a homicide victim's family member or close friend, you have the opportunity to use this victim impact statement to describe how the loss of your loved one has affected you and others close to you. You do not have to use the statement. If you prefer, you may wish to write a letter to judge instead. If you choose to use this statement, there is space for you to write about the emotional and financial effects this crime has caused you and those close to you, as well as any other changes in your life you may have experienced. If the defendant pleads guilty or is found guilty after trial, your impact statement will help the judge understand how this crime has affected you, your family and those close to you.

Filling out this statement is voluntary

You do not have to fill out a victim impact statement. However, it may be helpful to the judge when he or she decides what sentence the defendant should receive and/or any money the defendant may have to pay you or other family members for expenses you have paid or owe because of this crime. When the judge makes the defendant pay the victim's family, it is called "restitution." If the judge orders the defendant to pay you or your family restitution, there is no guarantee that the defendant will be able to pay the entire amount.

Your statement will become an official court document after it is given to the court, and will become part of the defendant's permanent file. Judges, prosecutors, and probation officers may read your statement. In addition, prison and parole officials may read it if the defendant is sentenced to a prison term. The defendant and the defendant's attorney will be able to read what you have written. They may even be able to ask you questions about your statement in court. However, the defendant will not be able to see your address and telephone number because you are not asked to put them on your statement.

No one knows better than you how this crime may have changed your life. Those of us involved in the prosecution of this case believe that it is very important for you to help the court understand all of the ways this crime has affected you and those near you. Thank you for taking the time to provide us with this information.

[In applicable jurisdictions: You also have the right to speak to the judge at the time of sentencing. If you would like to do so, please contact our office right away and we will help set this up for you.]

[In applicable jurisdictions: You also have the right to give your victim impact statement in the form of an audio or video tape. If you would like to do this, please contact our office right away for further information.]

[In applicable jurisdictions: The statement also asks what you believe the sentence should be in this case. Although the judge will decide the defendant's sentence, the judge may consider your opinion before making this decision. Your statement also may be used at other hearings where decisions are made about parole or releasing the defendant early.]

Suggestions for Completing Your Impact Statement

The following suggestions are offered only as a guide in filling out this form. Feel free to write in your own words how this crime has affected you and those close to you. Please answer as many questions as you wish. If a question makes you feel uncomfortable, you do not have to answer it.

If you need more space to complete your statement or if you wish to provide information in a different way, please use as much paper as you need, and attach the pages to this form when you return it. If you feel uncomfortable in any way using this form, you may write a letter to the judge and tell him or her how this crime has affected you and those close to you.

The first part of the impact statement asks you two questions about:

* The emotional impact of this crime on you and your family.

* The effect of the crime on your ability to work or do any of the things you normally do, such as going to school, running a household, or any other activities you normally perform or enjoy.

If you would like to and feel comfortable in doing so, you may wish to write about what kind of person your loved one was and what he or she meant to you. You may wish to tell the judge some of your loved one's interest, hopes, dreams or you may wish to write something about the special memories you have of your loved one.

If you have paid or owe any money for bills because of this crime, please fill out the financial impact section of the statement. It is important to be as accurate and complete as you can when listing your costs because this information will be used by the prosecutor, probation officer and the judge to help them determine what restitution the defendant must pay to you. Some examples of expenses you may have paid or owe include medical bills or expenses; counseling costs; lost wages or loss of support; funeral expenses; crime scene cleanup; and, the repair or replacement of door locks and security devices. It is important to attach copies of any bills or other proof of any money you have spent or expect to spend in the future.

In addition to medical or counseling bills, you may want to include any time off from work that you were not paid for as a result of this crime. For example, if you took time off from work to go attend to your loved one's medical care or funeral arrangements, and your employer did not pay you for this time, you may want to ask the judge to think about these expenses when he or she decides if the defendant will owe you any restitution.

Crime Victim Compensation

Did you know that you may be able to receive financial help from a state crime victim compensation program? This program can pay victims and family members of homicide victims for certain types of out-of-pocket expenses for physical or emotional injuries received as a direct result of a crime. These expenses include medical bills, counseling costs, funeral bills, and lost wages and support. This is not the same as restitution. You may be able to receive money to help you with some of the medical bills even before you go to court.

You will have to meet certain conditions to receive Crime Victim Compensation benefits, but you can file for benefits immediately following the crime even if no arrest has been made. If you would like more information on the benefits available, or how to apply for compensation, please contact our office for assistance.

For Help With Your Victim Impact Statement

Please return your completed impact statement to our office within 10 days. If you have any questions while writing your impact statement or if you would like to speak to the judge at sentencing, please contact our office right away so we can help set this up for you. If our office can help you in any way at all, please feel free to contact us at:

(Your printed organizational name goes here with contact name, phone number and mailing address.)

Victim Impact Statement

If you need more space to answer any of the following questions, please feel free to use as much paper as you need, and simply attach these sheets of paper to this impact statement. You do not have to use this form. If you prefer, feel free to write a letter to the judge. This form is only offered to provide you with an example of what you may wish to write about. Thank you.

Your Name

Your Loved One's Name

Defendant's Name(s)

1. How has the loss of your loved one affected you and those close to you? Please feel free to discuss your feelings about what has happened and how it has affected your general well-being. Has this crime affected your relationship with any family members, friends, co-workers, and other people? As a result of this crime, if you or others close to you have sought any type of victim services, such as counseling by either a licensed professional, member of the clergy, or a community-sponsored support group, you may wish to mention this.

2. Has this crime affected your ability to perform your work, make a living, run a household, go to school, or enjoy any other activities you previously performed or enjoyed? If so, please explain how these activities have been affected by your loss.

3. Only if you feel comfortable in doing so should you use this space to tell the judge anything you would like him or her to know about your loved one and the kind of person he or she was. If you wish, you can write about any special memories you have of your loved one, times you shared together, what his or her hopes and dreams were, and any other information you would like to share with the judge.