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Petition To Modify Bifurcated Sentence (Geriatric-Extraordinary Health Condition) CR-254 - Wisconsin
| Petition To Modify Bifurcated Sentence (Geriatric-Extraordinary Health Condition) Form. This is a Wisconsin form and can be used in Criminal Circuit Court Statewide . |
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For Official Use STATE OF WISCONSIN, CIRCUIT COURT, State of Wisconsin -vs, Defendant Name COUNTY Amended Petition to Modify Bifurcated Sentence §302.113(9g) (Geriatric/Extraordinary Health Condition) Case No. . Date of Birth 1. I was sentenced for the crime of , on (Date) · The total length of my bifurcated sentence on this count is years, months. · My initial term of confinement in prison is years, months. · My initial term of extended supervision is years, months. I was sentenced for the crime of , on (Date) · The total length of my bifurcated sentence on this count is years, months. · My initial term of confinement in prison is years, months. · My initial term of extended supervision is years, months. I was sentenced for the crime of , on (Date) · The total length of my bifurcated sentence on this count is years, months. · My initial term of confinement in prison is years, months. · My initial term of extended supervision is years, months. . . 2. 3. I am not serving a sentence for a Class A or B felony. A. I have not previously filed a petition for modification of bifurcated sentence. OR B. I have previously had a petition for modification of bifurcated sentence denied by the Program Review Committee. The denial was on (Date) , and it has been over one year since that denial. OR C. I have previously had a petition for modification of bifurcated sentence denied by the court. The denial was on (Date) , and it has been over one year since that denial. A. I am 65 years of age or older and have served at least 5 years of the term of confinement in prison. OR B. I am 60 years of age or older and have served at least 10 years of the term of confinement in prison. OR C. I have an extraordinary health condition, and have attached affidavits from two (2) physicians setting forth a diagnosis that I have an extraordinary health condition. 4. 5. My attorney's name(if any): Address: Telephone: 6. I request appointment of an attorney. 7. I request sentence modification. Fax: Petitioner Name Typed or Printed DISTRIBUTION: 1. Program Review Committee Original CR-254, 08/11 Petition to Modify Bifurcated Sentence §302.113(9g) Date §302.113(9g), Wisconsin Statutes American LegalNet, Inc. www.FormsWorkFlow.com This form shall not be modified. It may be supplemented with additional material.
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