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Restitution Worksheet Notice And Order CR-611 - North Carolina
| Restitution Worksheet Notice And Order Form. This is a North Carolina form and can be used in Criminal Statewide . |
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File No. STATE OF NORTH CAROLINA In The General Court Of Justice County District Superior Court Division STATE VERSUS RESTITUTION WORKSHEET, NOTICE Name And Address Of Defendant AND ORDER (INITIAL SENTENCING) G.S. 15A-1340.34 through -1340.38, 15A-1343(d) Social Security No. Of Defendant Has No Social Security No. NOTE: District Attorneys office should enter total restitution sought in Part I of this form, enter available information for each aggrieved party and victim, including amount of restitution sought for that person, in Parts II and III, and provide this information to the Court at the sentencing hearing. Use this form to compute and order restitution when the defendant is initially sentenced. Use the "Restitution Update Worksheet And Findings - Revocation Or Termination Of Probation," AOC-CR-612, to compute balance of restitution due on revocation or termination of probation. Use Side Two of this form only when there are Victims Rights Act victims for whom restitution is sought or ordered. I. TOTAL RESTITUTION TO BE PAID BY DEFENDANT Requested: $ NOTE: Enter sum of all restitution ordered in Parts II and III. Also enter this amount on criminal judgment. Granted, If Different: $ II. NON-VICTIMS RIGHTS ACT AGGRIEVED PARTIES TO RECEIVE RESTITUTION NOTE:Use Part III on reverse side to list persons who are victims under G.S. 15A-1340.34(a) (Victims Rights Act). List here all other aggrieved parties for whom the State requests restitution. AMOUNT OF AGGRIEVED PARTY INFORMATION RESTITUTIONName And Address Victim requests post-conviction notification. Telephone No. Requested: $ Social Security No./Taxpayer ID No. Granted, If Different: Account No. $ The defendant is held jointly and severally liable. If available, enter law enforcement incident number, names of other defendants and file numbers. Name And Address Victim requests post-conviction notification. Telephone No. Requested: $ Social Security No./Taxpayer ID No. Granted, If Different: Account No. $ The defendant is held jointly and severally liable. If available, enter law enforcement incident number, names of other defendants and file numbers. Name And Address Victim requests post-conviction notification. Telephone No. Requested: $ Social Security No./Taxpayer ID No. Granted, If Different: Account No. $ The defendant is held jointly and severally liable. If available, enter law enforcement incident number, names of other defendants and file numbers. Name And Address Telephone No. Requested: Victim requests post-conviction notification. $ Social Security No./Taxpayer ID No. Granted, If Different: Account No. $ The defendant is held jointly and severally liable. If available, enter law enforcement incident number, names of other defendants and file numbers. AOC-CR-611, Rev. 9/02 2002 Administrative Office of the Courts (Over) <<<<<<<<<********>>>>>>>>>>>>> 2 III. VICTIMS RIGHTS ACT VICTIMS NOTE:List here each person "directly and proximately harmed as a result of the defendants commission" of a criminal offense to which the Victims Rights Act applies. G.S. 15A-1340.34(a). If there is any such victim, Part IV must also be completed. VICTIMS NOTICE INFORMATION AMOUNT OF (NOTE: If victim has refused to disclose any information, so state.) RESTITUTIONName And Address Victim requests post-conviction notification.Telephone No. Requested: $ Granted, If Different: Social Security No./Taxpayer ID No. $ Docketing Info (See Note)Contact Person Race Sex DOB Book No. Page No. The defendant is held jointly and severally liable. If available, enter law enforcement incident number, names of other defendants and file numbers. Name And Address Victim requests post-conviction notification.Telephone No. Requested: $ Granted, If Different: Social Security No./Taxpayer ID No. $ Docketing Info (See Note)Contact Person Race Sex DOB Book No. Page No. The defendant is held jointly and severally liable. If available, enter law enforcement incident number, names of other defendants and file numbers. IV. ORDER FOR RESTITUTION NOTE: Complete only if Part III is completed. The Court, having considered the information presented by the parties about the loss or damage caused by the offense(s) of which the defendant has been convicted and about the resources of the defendant, ORDERS that the defendant pay to each victim named in Part III above the "Amount Of Restitution" shown opposite that victims name. That amount is: full restitution for each victim. partial restitution for the victim(s), and is ordered for the following reasons: [State reasons for ordering partial restitution. G.S. 15A-1340.36(a)] (Check whenever applicable) The defendant was ordered to pay restitution as a condition of probation. (Check, if applicable, when defendants most serious offense is a misdemeanor) The defendant was convicted of a misdemeanor offense specified in G.S. 15A-830(a)(7)g. and the offense was committed between persons who have a personal relationship as defined in G.S. 50B-1(b). Date Name Of Judge (Type Or Print) Signature Of Judge NOTE TO CLERK: Retain original criminal judgment, with this Restitution Worksheet, Notice And Order attached, in the criminal file. Provide a copy to your bookkeeping department. If Parts III and IV are completed, and the Court has ordered restitution in an amount in excess of two hundred fifty dollars ($250.00) to any victim, provide a copy of this form to your civil department. Attach a copy of this form to the judgment and mail to the Department of Correction, Combined Records, 2020 Yonkers Road, 4226 MSC, Raleigh, NC 27699-4226, or other agency receiving custody of defendant. G.S. 15A-832g. NOTE TO BOOKKEEPER: On the bill of costs in the Financial Management System, enter restitution information, along with information from the criminal judgment about any fine, costs, attorneys fee and community service fee to be paid by the defendant, whenever the defendant is (1) given time to pay, (2) placed on supervised or unsupervised probation, or (3) sentenced to an active sentence and the Court recommends the payment of any amount as a condition of post-release supervision or from work release earnings. Use account code 26120, distribution priority 3, for each Victims Rights Act victim listed in Part III, unless otherwise ordered. NOTE TO CIVIL DEPARTMENT: The order for restitution shall be docketed and indexed in the county of original conviction in the same manner as a civil judgment pursuant to G.S. 1-233, et seq. G.S. 15A-1340.38(b). I
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