Please, print clearly the answer for each question in the boxes.
CODING SHEET NUMBER # (F or S)-(number)
-





2.1 Crown attorney file number















2.2 CPIC (Canadian Police Information Centre) number If no CPIC number, please leave it blank















3.1 Date of birth Year 


Month 
Day 

3.2 Gender
Male
Female3.3 Ethnic group
Inuit (as identified through name)
Inuit (as identified in file)
Other Aboriginal (as identified in file)
Caucasian
Other:
Unknown3.4 Marital status at the time of the instant[12] offence/s
Single
Common-law[13]
Married
Divorced
Separated
Widowed
Unknown3.5 Living arrangements at the time of the instant offence/s
Alone
With spouse/common-law
With spouse/common-law and children (or step-children)
With children (or step-children) only
With parents
With other relatives. Please specify:
With friends
Transient[14]
Other:
Unknown3.6 Birth community of the accused
Northwest Territories
Outside NWT
Aklavik
Colville Lake
Deline
Fort Good Hope
Fort McPherson
Holman
Inuvik
Norman Wells
Paulatuk
Sachs Harbour
Tssigehtchic
Tuktoyaktuk
Tulita
Ford Liard
Fort Providence
Jean Marie River
Kakisa Lake
Nahanni Butte
Wrigley
Trout Lake
Rae Edzo
Gameti
Wha Ti
Wekweto (Snare Lakes)
Enterprise
Hay River Reserve[15]
Hay River
Fort Resolution
Lutselk’e
Fort Smith
Yellowknife
NWT but community unknown
Nunavut
Yukon
Other Canada
Outside Canada
Fort Simpson
Unknown3.7 Community in which the instant offence/s occurred
Northwest Territories
Outside NWT
Aklavik
Colville Lake
Deline
Fort Good Hope
Fort McPherson
Holman
Inuvik
Norman Wells
Paulatuk
Sachs Harbour
Tssigehtchic
Tuktoyaktuk
Tulita
Ford Liard
Fort Providence
Jean Marie River
Kakisa Lake
Fort Simpson
Nahanni Butte
Wrigley
Trout Lake
Rae Edzo
Gameti
Wha Ti
Wekweto (Snare Lakes)
Enterprise
Hay River Reserve[16]
Hay River
Fort Resolution
Lutselk’e
Fort Smith
Yellowknife
NWT but community unknown
Multiple communities.
Nunavut
Yukon
Other Canada
Outside Canada
Unknown 3.8 Work status at the time of the instant offence/s
Traditional work only, such as hunting, fishing, artwork, other
Employed for pay and doing traditional work
Employed for pay full time
Employed for pay part time or seasonally
Employed for pay but full time or part time is unknown
Unemployed
Student
Other. Please specify

Unknown3.9 Highest level of education achieved at the time of the instant offence/s
Illiterate or no school
Primary/elementary school
Secondary school
High school diploma
Some community or college
Community or college degree
Some university education
University degree
Post-graduate degree
Unknown4.1 Known victimization of accused[17] (Check all that apply.)
No victimization
Yes, physical victimization
Yes, emotional victimization
Yes,sexual victimization
Unknown4.2 Any history of suicidal attempts?
Yes
No
Unknown4.2 (b) Any history of suicidal ideation?
Yes
No
Unknown4.3 Any history of violent behaviour?
Yes
No
Unknown4.4 Who raised the accused? (Check all that apply.)
Parents
Adoptive/Foster parents
Grandparents
Other family members
Other. Please specify:

Unknown4.5 Any history (past and/or up to the instant offence/s) of substance abuse. ( Check all that apply.)
No (Go to Part 5)
Yes,alcohol/home brew
Yes,drugs or other substance/s
Yes, but substance not clear
Unknown (Go to Part 5)4.6 If yes to drugs, please specify which one. (Check all that apply.)
Cannabis
Hashish
Glue
Gasoline
Cocaïne
Heroïne
Ecstasy
Other. Please specify:

Unknown4.7 If yes to any kind of substance abuse, what is the extent?
Occasional
Occasional but heavy quantity
Regularly, i.e., more than once a week (no matter the quantity)
Unknown4.8 Did the accused receive any treatment for substance abuse?
Yes, just once
Yes, more than once
Yes, but don’t know to what extent
No
Unknown5.1 Charge[18] #sec1 


5.1 (a) If initial charge was dropped to a lesser charge, code the lesser charge
5.2 Date #sec1 (From) Year 


Month 
Day 
(To) Year 


Month 
Day 
5.3 Plea#sec1 (Offender)
5.4 Decision/disposition #sec1 (Judge/Jury)
Charge withdrawn, stayed 01
Not guilty/acquittal
Pleads not guilty at first appearance, then pleads guilty at a later stage 02
Peace bond
Pleads not guilty, but charge is withdrawn/stayed by Crown at a later stage.
Judicialstay (by Judge) Reason:

Withdrawn by Crown Counsel
Not Guilty
Guilty 06
Not criminally responsible
Unknown 07
Unfit to stand trial
Other. Please specify:

Crown Counsel stay
Unknown5.5 What date was the complaint made by the victim/s? OR 5.5 (a) Date of offender’s confession
Year 


Month 
Day 

5.6 What date was the accused arrested? Year 


Month 
Day 

5.7 Date of decision/disposition #sec1 Year 


Month 
Day 

5.8 Date of sentence #sec1 Year 


Month 
Day 

5. 9 What was the sentence for offence #sec1? ( Check all that apply.)
Absolute discharge
Conditional discharge and probation. Please write the number of days of probation:



Suspended sentence and probation. Please write the number of days of probation:



Conditional sentence. Please write the number of days: 


Please complete question 6.6
Fine/Restitution. Please write the dollar amount of fine/restitution:



Personal services. Please describe:

Compensation order. Please describe:

Community service. Please write the type of community service:

Attend program. Please write what kind of program:

Probation. Please write the number of days of probation: 


Please complete question 6.5
Time served. Please write the number of days in time served prior to sentencing:



Custody. Please write the number of days of custody:



Intermittent custody. Please write the number of days in intermittent custody:



Other. Please specify:

Unknown 5.10 Charge #2 5.10 (a) If initial charge was dropped to a lesser charge, code the lesser charge
5.11 Date #2 


(From) Year 


Month 
Day 
(To) Year 


Month 
Day 

5.12 Plea#2 (Offender)
5.13 Decision/disposition #2 (Judge/Jury)
Charge withdrawn, stayed
Not guilty/acquittal
Pleads not guilty at first appearance, then pleads guilty at a later stage
Peace bond
Pleads not guilty, but charge is withdrawn/stayed by Crown at a later stage.
Judicialstay (by Judge) Reason:

Withdrawn by Crown Counsel
Not Guilty
Guilty
Not criminally responsible
Unknown
Unfit to stand trial
Other. Please specify:

Crown Counsel stay
Unknown5.14 What date was the complaint made by the victim/s? OR 5.14 (a) Date of offender’s confession



Month 
Day 

5.15 What date was the accused arrested? Year 


Month 
Day 

5.16 Date of decision/disposition #2 Year 


Month 
Day 

5.17 Date of sentence #2 Year 


Month 
Day 

5. 18 What was the sentence for offence #2? ( Check all that apply.)
Absolute discharge
Conditional discharge and probation. Please write the number of days of probation:



Suspended sentence and probation. Please write the number of days of probation:



Conditional sentence. Please write the number of days: 


Please complete question 6.6
Fine/Restitution. Please write the dollar amount of fine/restitution:



Personal services. Please describe:

Compensation order. Please describe:

Community service. Please write the type of community service:

Attend program. Please write what kind of program:

Probation. Please write the number of days of probation: 


Please complete question 6.5
Time served. Please write the number of days in time served prior to sentencing:



Custody. Please write the number of days of custody:



Intermittent custody. Please write the number of days in intermittent custody:



Other. Please specify:

Unknown 5.19 Charge #3


5.19 (a) If initial charge was dropped to a lesser charge, code the lesser charge
5.20 Date #3 (From) Year 


Month 
Day 
(To) Year 


Month 
Day 

5.21 Plea #3 (Offender)
5.22 Decision/disposition #3 (Judge/Jury)
Charge withdrawn, stayed
Not guilty/acquittal
Pleads not guilty at first appearance, then pleads guilty at a later stage
Peace bond
Pleads not guilty, but charge is withdrawn/stayed by Crown at a later stage.
Judicialstay (by Judge) Reason:

Withdrawn by Crown Counsel
Not Guilty
Guilty
Not criminally responsible
Unknown
Unfit to stand trial
Other. Please specify:

Crown Counsel stay
Unknown5.23 What date was the complaint made by the victim/s? OR 5.23 (a) Date of offender’s confession



Month 
Day 

5.24 What date was the accused arrested? Year 


Month 
Day 

5.25 Date of decision/disposition #3 Year 


Month 
Day 

5.26 Date of sentence #3 Year 


Month 
Day 

5. 27 What was the sentence for offence #3? ( Check all that apply.)
Absolute discharge
Conditional discharge and probation. Please write the number of days of probation:



Suspended sentence and probation. Please write the number of days of probation:



Conditional sentence. Please write the number of days:


Please complete question 6.6
Fine/Restitution. Please write the dollar amount of fine/restitution:



Personal services. Please describe:

Compensation order. Please describe:

Community service. Please write the type of community service:

Attend program. Please write what kind of program:

Probation. Please write the number of days of probation: 


Please complete question 6.5
Time served. Please write the number of days in time served prior to sentencing:



Custody. Please write the number of days of custody:



Intermittent custody. Please write the number of days in intermittent custody:



Other. Please specify:

Unknown 5.29 Date #sec4 (From) Year 


Month 
Day 
(To) Year 


Month 
Day 

5.30 Plea#sec4 (Offender)
5.31 Decision/disposition #sec4 (Judge/Jury)
Charge withdrawn, stayed
Not guilty/acquittal
Pleads not guilty at first appearance, then pleads guilty at a later stage
Peace bond
Pleads not guilty, but charge is withdrawn/stayed by Crown at a later stage.
Judicialstay (by Judge) Reason:

Withdrawn by Crown Counsel
Not Guilty
Guilty
Guilty
Not criminally responsible
Unknown
Unfit to stand trial
Other. Please specify:

Crown Counsel stay
Unknown5.32 What date was the complaint made by the victim/s? OR 5.32 (a) Date of offender’s confession
Year 


Month 
Day 

5.33 What date was the accused arrested? Year 


Month 
Day 

5.34 Date of decision/disposition #sec4 Year 


Month 
Day 

5.35 Date of sentence #sec4 Year 


Month 
Day 

5. 36 What was the sentence for offence #sec4? ( Check all that apply.)
Absolute discharge
Conditional discharge and probation. Please write the number of days of probation:



Suspended sentence and probation. Please write the number of days of probation:



Conditional sentence. Please write the number of days: 


Please complete question 6.6
Fine/Restitution. Please write the dollar amount of fine/restitution:



Personal services. Please describe:

Compensation order. Please describe:

Community service. Please write the type of community service:

Attend program. Please write what kind of program:

Probation. Please write the number of days of probation:


Please complete question 6.5
Time served. Please write the number of days in time served prior to sentencing:



Custody. Please write the number of days of custody:



Intermittent custody. Please write the number of days in intermittent custody:



Other. Please specify:

Unknown 5.37 Charge #sec5
5.37(a) If initial charge was dropped to a lesser charge, code the lesser charge
5.38 Date #sec5 (From) Year 


Month 
Day 
(To) Year 


Month 
Day 
5.39 Plea#sec5 (Offender)
5.40 Decision/disposition #sec5 (Judge/Jury)
Charge withdrawn, stayed
Not guilty/acquittal
Pleads not guilty at first appearance, then pleads guilty at a later stage
Peace bond
Pleads not guilty, but charge is withdrawn/stayed by Crown at a later stage.
Judicialstay (by Judge) Reason:

Withdrawn by Crown Counsel
Not Guilty
Guilty
Not criminally responsible
Unknown
Unfit to stand trial
Other. Please specify:

Crown Counsel stay
Unknown5.41 What date was the complaint made by the victim/s? OR 5.41 (a) Date of offender’s confession



Month 
Day 

5.42 What date was the accused arrested? Year 


Month 
Day 

5.43 Date of decision/disposition #sec5 5.44 Date of sentence #sec5



Month 
Day 

5. 45 What was the sentence for offence #sec5? ( Check all that apply.)
Absolute discharge
Conditional discharge and probation. Please write the number of days of probation:



Suspended sentence and probation. Please write the number of days of probation:



Conditional sentence. Please write the number of days: 


Please complete question 6.6
Fine/Restitution. Please write the dollar amount of fine/restitution:



Personal services. Please describe:

Compensation order. Please describe:

Community service. Please write the type of community service:

Attend program. Please write what kind of program:

Probation. Please write the number of days of probation:


Please complete question 6.5
Time served. Please write the number of days in time served prior to sentencing:



Custody. Please write the number of days of custody:



Intermittent custody. Please write the number of days in intermittent custody:



Other. Please specify:

Unknown 5.46 Are there any additional charges?
No
Yes. Please specify the number of additional charges:Please attach and fill in a charge form for each additional charge.
IF OFFENDER FOUND GUILTY ON CURRENT CHARGE/S If not found guilty on any charges, go directly to part 7
6.1 Was there a request for community banishment?
Yes
No
Unknown6.2 Was there a prohibition for firearms/weapons?
Yes
No
Unknown6.3 If custody for sexual and/or spousal assault, is it concurrent or consecutive?
Neither concurrent or consecutive because only 1 order
Concurrent
Consecutive
N/A
Unknown6.4 If custody (under YCJA[19] only) for sexual and/or spousal assault, is it open or secure or both?
Open
Secure
Both Open and Secure. Number of days for Open: 


Number of days for Secure: 



N/A
Unknown6.5 If probation, please check the conditions. (Check all that apply)
Not applicable
Conditions not on file.
You must keep the peace and be of good behaviour.
You must promptly notify the court or probation officer or supervisor of any change of employment or occupation.
You must appear before the Court when required to do so.
You must notify the Court or your probation officer in advance of any change of name or address.
You must attend Court on the
day of
, (year) at
for the purpose of
.
You must report to a probation officer on
and thereafter as directed
you will be under the supervision of the probation officer.
You must remain within the jurisdiction of the court unless written permission to go outside that jurisdiction is obtained from the court or the probation officer or supervisor.
You must reside at
until further order of this court, and you will obey the rules of that residence OR in a residence or place as directed by your probation officer.
You must obey a curfew and be inside your residence between the hours of
p.m. and
a.m. daily unless you have been given written permission to be away from your home by your parents/probation officer/RCMP.
You must not approach within (number) meters of the residence or place of employment of victims.
You must abstain absolutely from the possession or consumption of any intoxicating substances (including alcohol) unless a physician lawfully prescribes the substance.
You must not be present in any residence/establishment where alcohol is being served.
You must not be under the influence of alcohol to any degree in a public place.
You must seek or maintain employment and provide a monthly report to your probation officer on your efforts to do so.
You will attend school regularly.
You will attend such educational or recreational programs as may be
directed by your probation officer and not be absent from these programs without the permission of your probation officer.
You must undergo an assessment (e.g. alcohol, psychological). Please describe:

You will attend counselling (e.g. family, anger management counselling, addictions counselling, alcohol counselling) directed by your probation officer. Please describe:

You must take a treatment
program. Please specify what kind:

You must perform 
hours of community service work as and when directed to do so by your probation officer his or her lawful designate) and to his or her satisfaction, to be completed by
.
You must pay restitution in the amount of $ 


to be paid in full by
.
You must perform 
hours of work service for the benefit of
(if consented to by the victim in writing) and to the satisfaction of your probation officer, to be completed by
.
You must make reasonable efforts to provide for the support and care
of
.
You must have no direct or indirect contact with (the victim).
If (the victim) initiates contact with you, you must immediately notify your probation officer.
You must not resume cohabitation with victim.
You must not be present with children under the age of 
years old unless a reasonable adult is present.
You may not possess or carry any firearm or ammunition within any community in NWT. You may use a gun only for hunting while out on the land (in the company of a responsible adult).
You must meet with the Justice Committee as directed by your probation officer for the purpose of receiving traditional counselling or providing an in person apology to the victim.
You must immediately leave the presence of
when you are requested to do so by her/him, or a member of the RCMP, and you must have no further contact with this person for a period of twenty-four hours following such a request.
Other condition. Please describe:

6.6 If conditional sentence, please check the conditions. (Check all that apply.)
Not applicable
Conditions not on file.
You must keep the peace and be of good behaviour.
You must promptly notify the court or probation officer or supervisor of any change pf employment or occupation.
You must appear before the Court when required to do so.
You must notify the Court or your probation officer in advance of any change of name or address.
You must attend Court on the
day of
, (year) at
for the purpose of
.
You must report to a probation officer on
and thereafter as directed
you will be under the supervision of the probation officer.
You must remain within the jurisdiction of the court unless written permission to go outside that jurisdiction is obtained from the court or the probation officer or supervisor.
You must reside at
until further order of this court, and you will obey the rules of that residence OR in a residence or place as directed by your probation officer.
You must obey a curfew and be inside your residence between the hours of
p.m. and
a.m. daily unless you have been given written permission to be away from your home by your parents/probation officer/RCMP.
You must not approach within (number) meters of the residence or place of
employment of victims.
You must abstain absolutely from the possession or consumption of any intoxicating substances (including alcohol) unless a physician lawfully prescribes the substance.
You must not be present in any residence/establishment where alcohol is being served.
You must not be under the influence of alcohol to any degree in a public place.
You must seek or maintain employment and provide a monthly report to your probation officer on your efforts to do so.
You will attend school regularly.
You will attend such educational or recreational programs as may be
directed by your probation officer and not be absent from these programs without the permission of your probation officer.
You must undergo an assessment (e.g. alcohol, psychological). Please describe:
You will attend counselling (e.g. family, anger management counselling, addictions counselling, alcohol counselling) directed by your probation officer. Please describe:

You must take a treatment
program. Please specify what kind:

You must perform 
hours of community service work as and when directed to do so by your probation officer (or his or her lawful designate) and to his or her satisfaction, to be completed by
.
You must pay restitution in the amount of $ 


to be paid in full by
.
You must perform 
hours of work service for the benefit of
(if consented to by the victim in writing) and to the satisfaction of your probation officer, to be completed by
.
You must make reasonable efforts to provide for the support and care
of
.
You must have no direct or indirect contact with (the victim).
If (the victim) initiates contact with you, you must immediately notify your probation officer.
You must not resume cohabitation with victim.
You must not be present with children under the age of 
years old unless a reasonable adult is present.
You may not possess or carry any firearm or ammunition within any community in NWT. You may use a gun only for hunting while out on the land (in the company of a responsible adult).
You must meet with the Justice Committee as directed by your probation officer for the purpose of receiving traditional counselling or providing an in person apology to the victim.
You must immediately leave the presence of
when you are requested to do so by her/him, or a member of the RCMP, and you must have no further contact with this person for a period of twenty-four hours following such a request.
Other condition. Please describe:7.1 What file are these current offences from?
Youth file (Youth Criminal Justice Act -YCJA)
Adult file (Criminal Code)
Both youth and adult files
Unknown7.2 Was the accused on probation at time of charge?
Yes
No
Unknown7.3 Was the accused on parole at time of charge?
Yes
No
Unknown7.4 Was the accused under charge for other crimes when arrested? Please write the codes of the 4 most serious charges (See Appendix B for severity scale)
Yes. Charge #sec1 


Charge #2 


Charge #3 


Charge #sec4 



No
Unknown7.5 Was the offender detained?
No, never
Yes, by police after arrest
Yes, by Justice of Peace by bail hearing
Yes, during case processing after a warrant issued
Yes, during case processing on another charge
Yes, by the court during case processing for other reason. Please specify:

Yes, multiple detentions after arrest
Yes, other (e.g. yes, detained but dk whether 2 or 3 or 4; in custody all the time)
Unknown7.6 Was the accused represented by counsel when in court?
Yes
No
Unknown7.7 If accused represented by counsel, was it a legal aid counsel?
Yes
No
Unknown7.8 Was the accused diverted to an alternative justice?
No
Yes. The accused was referred to community justice (community justice committee).
Yes. The accused was referred to alternative justice, other than community justice. Please specify:

Alternative or community justice was suggested but not available.
Unknown7.9 Date of first appearance in court Year 


Month 
Day 

7.10 Date of last appearance in court (or date of completion of file)?



Month 
Day 

7.11 Number of hearings 

7.12 Is there any indication of lack of knowledge of English by the accused when in court?
Yes. Please explain:

No
Unknown7.13 Was a trial date set for the instant offence/s?
Yes
No (Go to Q 7.15)
Unknown7.14 If yes, did a trial actually take place?
Yes (Go to Q 7.16)
No
Unknown7.15 If no trial took place, why not?
Accused plead guilty from the right beginning.
Accused changed plea.
Plea bargain to plead to a lesser charge
Crown ould not proceed with trial due to problems with evidence, witnesses, etc.
Other. Please specify:

Unknown7.16 Date of first trial Year 


Month 
Day 

7.17 Was it a trial before a judge alone or a trial before a jury?
A judge alone
A judge and jury
Unknown7.18 Was the verdict appealed?
Yes
No
No. The request was denied.
Unknown


Charge #2 


Charge #3 


Charge #sec4 



7.20 Was the Appeal successful?
Yes, on the verdict only.
Yes, on the sentence only.
Yes, on both the verdict and the sentence.
No
Unknown


Charge #2: 


Charge #3: 


Charge #sec4: 


8.1 Alcohol and or drug consumption of accused preceeding or as part of the most severe incident of sexual or spousal assault?
No (Go to Q 8.3)
Yes,alcohol only
Yes,drug/s only
Yes,both alcohol & drugs
Yes,some alcohol or drugs consumed prior to incident but unknown what substances were consumed
Yes,some other substances such as glue, gasoline
Unknown8.2 What type of substance did the accused use at time of offence? (Check all that apply).
Cannabis
Hashish
Glue
Gasoline
Cocaïne
Heroïne
Ecstasy
Other. Please specify:

Unknown 8.3 Was a weapon involved in the offence?
Yes
No (Go to 8.5)
Unknown (Go to 8.5)8.4 If yes, what kind of weapon? (Check all that apply)
Blunt instrument, e.g., hard or heavy object such as a chair, a baseball ball, unbroken beer bottle, wooden stick.
Knife
Other piercing or cutting instrument, e.g., hatchet, razor blade, broken bottle. Please specify: 
Firearm-type weapon, but not a firearm (BBgun, facsimile gun, starter’s pistol, pellet pistol, etc.). Specify:

Firearm (rifle, shotgun, handgun). Please specify:

Other. Please specify:

Unknown8.5 Is it alleged that the accused committed his/her crime with anyone else?
No
Yes
Unknown8.6 If yes, how many others? 

8.7 If yes, what is the number of co-accused?[21] 

9.1 Number of victim/s who were injured 

9.2 Age of Victim #sec1 

9.3 Sex of victim #sec1
Male
Female9.4 Was a Victim Impact Statement (VIS) prepared by the victim #sec1?
Yes
No9.5 Nature of the most serious physical injuries[22] for victim # 1
No injury.
Minor physical injury -injury that required no professional medical treatment or only some first aid, e.g. scratches, bruises, cuts, abrasions.
Major physical injury -injury that is more than “trifling”or
“transient”in nature and that required professional medical attention at the scene or transportation to a hospital emergency/outpatient department, e.g. stitches, broken bones.
Other. Please specify:

Unknown9.6 Nature of emotional trauma for victim # 1 (Check all that apply.)
No known emotional trauma.
Fear/Scare/Frightened
Angry
Behavioural change (e.g. cannot leave the house). Please specify:

Distress
Emotionally unstable. Please describe:

Depression
Suicidal ideas or attempts
Other. Please specify:

Unknown9.6 (a) Was the victim #sec1 under the influence of drugs or/and alcohol when the incident happened?
Yes. Please write what kind of substance:

No
Unknown9.6 (b) Was the offender under the influence of drugs or/and alcohol when he/she assaulted the victim #sec1?
Yes. Please write what kind of substance:

No
Unknown9.7 What is the relationship between the accused and the victim# 1? (Victim # 1 is the of the accused.)
Spouse
Common-law partner
Separated husband/wife
Divorced husband/wife
Same sex partner
Boyfriend/Girlfriend
Extra-marital lover
Son/Daughter
Step-child
Grand-child
Niece/Nephew
Sibling
Friend
Neighbour
Casual acquaintance
Stranger
Other:______
Student
Unknown9.7 (a) Did Victim #sec1 refuse to pursue charges?
Yes
No
Unknown9.7 (b) Did Victim #sec1 want to testify in court?
Yes
No. Victim #sec1 was a reluctant witness (did not want to testify from the right beginning)
No. Victim #sec1 was a recanting witness (wanted to testify at the beginning but did not want after)
Unknown9.8 Age of Victim #2 

9.9 Sex of victim #2
Male
Female9.10 Was a Victim Impact Statement (VIS) prepared by the victim #2?
Yes
No9.11 Nature of the most serious physical injuries for victim # 2
No injury.
Minor physical injury -injury that required no professional medical treatment or only some first aid, e.g. scratches, bruises, cuts, abrasions.
Major physical injury -injury that is more than “trifling”or
“transient”in nature and that required professional medical attention at the scene or transportation to a hospital emergency/outpatient department, e.g. stitches, broken bones.
Other. Please specify:

Unknown9.12 Nature of emotional trauma for victim # 2 (Check all that apply.)
No known emotional trauma.
Fear/Scare/Frightened
Angry
Behavioural change (e.g. cannot leave the house). Please specify:

Distress
Emotionally unstable. Please describe:

Depression
Suicidal ideas or attempts
Other. Please specify:

Unknown9.12 (a) Was the victim #2 under the influence of drugs or/and alcohol when the incident happened?
Yes. Please write what kind of substance:

No
Unknown
Yes. Please write what kind of substance:

No
Unknown9.13 What is the relationship between the accused and the victim #2? (Victim # 2 is the…of the accused.)
Spouse
Common-law partner
Separated husband/wife
Divorced husband/wife
Same sex partner
Boyfriend/Girlfriend
Extra-marital lover
Son/Daughter
Step-child
Grand-child
Niece/Nephew
Sibling
Friend
Neighbour
Casual acquaintance
Stranger
Other:
Student
Unknown9.13(a) Did Victim #2 refuse to pursue charges?
Yes
No
Unknown9.13 (b) Did Victim #2 want to testify in court?
Yes
No. Victim #2 was a reluctant witness (did not want to testify from the right beginning)
No. Victim #2 was a recanting witness (wanted to testify at the beginning but did not want after)
Unknown9.14 Age of Victim #3 

9.15 Sex of victim #3
Male
Female9.16 Was a Victim Impact Statement (VIS) prepared by the victim #3?
Yes
No9.17 Nature of the most serious physical injuries for victim # 3
No injury.
Minor physical injury -injury that required no professional medical treatment or only some first aid, e.g. scratches, bruises, cuts, abrasions.
Major physical injury -injury that is more than “trifling”or
“transient”in nature and that required professional medical attention at the scene or transportation to a hospital emergency/outpatient department, e.g. stitches, broken bones.
Other. Please specify:

Unknown9.18 Nature of emotional trauma for victim # 3 (Check all that apply.)
No known emotional trauma.
Fear/Scare/Frightened
Angry
Behavioural change (e.g. cannot leave the house). Please specify:

Distress
Emotionally unstable. Please describe:

Depression
Suicidal ideas or attempts
Other. Please specify:

Unknown9.18 (a) Was the victim #3 under the influence of drugs or/and alcohol when the incident happened?
Yes. Please write what kind of substance:

No
Unknown9.18 (b) Was the offender under the influence of drugs or/and alcohol when he/she assaulted the victim #3?
Yes. Please write what kind of substance:

No
Unknown9.19 What is the relationship between the accused and the victim#3? (Victim # 3 is the …of the accused.)
Spouse
Common-law partner
Separated husband/wife
Divorced husband/wife
Same sex partner
Boyfriend/Girlfriend
Extra-marital lover
Son/Daughter
Step-child
Grand-child
Niece/Nephew
Sibling
Friend
Neighbour
Casual acquaintance
Stranger
Other:
Student
Unknown
Yes
No
Unknown9.19 (b) Did Victim #3 want to testify in court?
Yes
No. Victim #3 was a reluctant witness (did not want to testify from the right beginning)
No. Victim #3 was a recanting witness (wanted to testify at the beginning but did not want after)
Unknown10.1 Was there a Victim Risk Assessment form completed?
Yes. Please copy the form and attach it to the questionnaire
No
Unknown11.1 Was the court provided with a predisposition report (PDR)? If the answer is “no”
, “N/A”
or “unknown”
, go to part 12.
Yes
No
N/A
Unknown11.2 Was there a recommendation for sentence in the PDR? (Check all that apply).
No recommendation discernable
Recommendation for custody (e.g. has not been successful on previous community dispositions)
Recommendation for community sentence
Other. Please specify:

Unknown11.3 What were the positive attributes in PDR for recommended sentence? (Check all that apply.)
Shows remorse
Victim empathy
Good attitude
Successful on previous dispositions, such as previous community sentences or alternatives measures
Accepts responsibility for the offence
First offence
Has employment
Has undertaken rehabilitation measures, counseling, etc.
Has offered to make restitution to victim
Stable family life
Has positive recommendation from community, employer, etc.
Other. Pleasespecify:
Unknown11.4 What were the negative attributes in PDR for recommended sentence? (Check all that apply.)
Shows no remorse
Shows no victim empathy
Unstable home/residential situation
Alcohol and or drug consumption or problem
Behaved badly on previous dispositions; did not respect conditions on previous community sentences
Large number of prior offences
Seriousness of prior record
Similarity of prior record to current offences
Escalation of seriousness of offences
Does not accept responsibility for the offence
History of violent behaviour whether or not charged
No stable employment
No stable residence
Other. Please specify:

Unknown12.1 Was any psychological or psychiatric report provided to the court?
Yes, a psychiatric report was provided.
Yes, a psychological report was provided.
Yes, both a psychological and a psychiatric report were provided.
No psychiatric or psychological report found in the file.12.2 Known disorders[23] or disabilities at the time of the instant offence (Check all that apply.)
No known disorder
Developmentally delayed/Low level functioning
Mental disability
Conduct disorder
Attention deficit disorder
Post-traumatic stress syndrome
Hyperactive
Minor depression
Major depression
Bordeline personality disorder
Substance abuse
Pedophilia
Sexual disorder. Please describe (e.g. paraphilia[24]):

Fetal alcohol spectrum disorder FAS/FAE/ARND)
Physical disability/physical health problems. Please describe:

Other. Please describe:_

Unknown12.3 Was there a recommendation for sentence or treatment in the psychological/psychiatric report? (Check all that apply.)
No recommendation discernable
Recommendation for open custody
Recommendation for secure custody
Recommendation for custody, but unknown if open or secure
Recommendation for community disposition
Recommendation for treatment. PleaseSpecify:

Other. PleaseSpecify:

Unknown12.4 Does the offender show remorse for the offence? This aspect of remorse has to be clearly mentioned in the report.
Yes
No
Unknown12.5 Does the offender accept responsibility for his or her actions? This aspect of responsibility has to be clearly mentioned in the report.
Yes, the offender accepts responsibility. Please write if it is full or partial responsibility: 
No, the offender does not accept responsibility.
Unknown12.6 Did the offender apologize to the victim(s)? It has to be clearly mentioned in the report that the offender apologize.
Yes
No
Unknown13.1 Was an order authorizing the taking of bodily substances for forensic DNA analysis requested?
Yes
No
Unknown13.2 Was a sexual kit administered?
Yes
No
Unknown13.3 Was the victim under the influence of drugs or/and alcohol when the sexual assault happen?
Yes. Please write what kind of substance:

No
Unknown13.4 Where was the victim sexually assaulted? (Check all that apply.)
At her/his own home
At the offender’s home
At the offender’ and victim’s home (when living together)
At a party
Inside a public place. Please describe:

Outdoor anywhere in the community. Please describe:

Other. Please describe:

Unknown13.5 Were there any witnesses?
Yes. How many: 
or at least: 
persons
No
Unknown13.6 If any witnesses, who were they? (Checkall that apply.)
Offender’s children
Victim’s children
Offender and victim’s children
Other children
Offender’s friends
Victim’s friends
Offender’s relatives
Victim’s relatives
Other adults
Other. Please describe:

Unknown13.7 If witnesses, did they try to impede the sexual assault?
Yes. Please describe:

No
Unknown13.8 If the victim was sexually assaulted by his/her partner or boyfriend/girlfriend, did the victim return to the relationship after the assault?
Yes. Please describe why (from the victim’s point of view):

No
No. Victim wanted to return to the relationship, but it did not happen for this particular reason[26]:
Unknown13.9 If the victimwas living with the offender, did they continue to cohabite after the sexualassault?
Yes
No
No. Victim wanted to cohabite, but the cohabitation did not happen for this particular reason[27]:
Unknown14.1 What was the rationale used by the offender to explain the assault on the victim?
14.2 Does the offender demonstrate a high tendency towards violence?
Yes
No
Unknown14.3 How long is/was the relationship between the offender and the victim when the assault happen?

days 14.4 Does the couple have children?
Yes. Please specify how many children reside with the couple:









No
Unknown14.4 (a) Was the victim pregnant when the assault happened?
Yes
No
Unknown14.4 (b) Did the victim assault the offender first?
Yes
No
Unknown14.4 (c) If the victim assaulted the offender first, did the victim use a weapon?
Yes. Please write the kind of weapon:

No
Unknown14.5 How many times the offender assaulted the victim before the instant offence/s?
The offender never assaulted the victim before
The offender assaulted the victim between one and five times before
The offender assaulted the victim more than five times before
The offender assaulted the victim before but unknown how many times
Unknown14.6 Where was the victim assaulted? (check all that apply.)
At her/his own home
At the offender’s home
At the offender’ and victim’s home (when living together)
At a party
Inside a public place. Please describe:

Outdoor in the community. Please describe:

Other. Please describe:

Unknown14.7 Were there any witnesses?
Yes. How many:
or at least: 
persons
Yes, but don’t know how many witnesses.
No
Unknown14.8 If any witnesses, who were they? (Check all that apply.)
Offender’s children
Victim’s children
Offender and victim’s biological children
Other children
Offender’s friends
Victim’s friends
Offender’s acquaintances
Victim’s acquaintances
Offender’s relatives
Victim’s relatives
Strangers
Other. Please describe:

Unknown14.9 If witnesses, did they try to impede the assault?
Yes. Please describe:

No
Unknown14.10 Did the victim return to the relationship with the offender after the assault?
Yes
No
No. Victim wanted to return to
the relationship, but it did not happen for this particular reason:
Unknown14.11 If the victim was living with the offender before the assault, did they continue to cohabite after the assault?
Yes
No
No. Victim wanted to cohabite,
but the cohabitation did not happen for this particular reason:
Unknown15.1 Any prior contact with the justice system? Includes charges laid but not proceeded with, Crown caution, prior findings of not guilty, dismissals, alternative measures as well as convictions.
No
Yes
Unknown15.2 Any prior convictions/findings of guilt?
No
Yes
Unknown15.3 If yes, what is the total number of prior convictions/findings of guilt (excluding the instant offence/s)?


15.4 What was the most serious offence? Please use codes in Appendix A.




15.5 What is the number of counts for this type of offence?


15.6 Date of the most serious offence. If different dates for the most serious offences, write the most recent



Month 
Day 

15.7 Any prior convictions for sexual assault ? Please exclude the instant offence/s
No
Yes. How many: 
Unknown15.8 Any prior convictions for assault? Please exclude the instant offence/s
No
Yes. How many: 

Unknown15.9 Any indicators of previous convictions for family violence
No
Yes. How many: 

UnknownIf any sexual assault or assault, please write the pertinent code for each offence, the date of conviction and the sentence:
15.10 code#sec1 


15.11 Year 


Month 
Day 

15.12 What was the sentence: (Check all that apply.)
Absolute discharge
Conditional discharge and probation. Please write the number of days of probation:



Suspended sentence and probation. Please write the number of days of probation:



Conditional sentence. Please write the number of days:



Fine/Restitution. Please write the dollar amount of fine/restitution:



Personal services. Please describe:
Compensation order. Please describe:
Community service. Please write the type of community service:
Attend program. Please write what kind of program:
Probation. Please write the number of days of probation:



Time served. Please write the number of days in time served prior to sentencing:



Custody. Please write the number of days of custody:



Intermittent custody. Please write the number of days in intermittent custody:



Other. Please specify:
Unknown15.13 code#2 



15.14 Year 


Month 
Day 

15.15 What was the sentence: (Check all that apply.)
Absolute discharge
Conditional discharge and probation. Please write the number of days of probation:



Suspended sentence and probation. Please write the number of days of probation:



Conditional sentence. Please write the number of days:



Fine/Restitution. Please write the dollar amount of fine/restitution:



Personal services. Please describe:
Compensation order. Please describe:
Community service. Please write the type of community service:
Attend program. Please write what kind of program:
Probation. Please write the number of days of probation:



Time served. Please write the number of days in time served prior to sentencing:



Custody. Please write the number of days of custody:



Intermittent custody. Please write the number of days in intermittent custody:



Other. Please specify:
Unknown15.16 code#3 15.17 Year 


Month 
Day 

15.18 What was the sentence: (Check all that apply.)
Absolute discharge
Conditional discharge and probation. Please write the number of days of probation:



Suspended sentence and probation. Please write the number of days of probation:



Conditional sentence. Please write the number of days:



Fine/Restitution. Please write the dollar amount of fine/restitution:



Personal services. Please describe:
Compensation order. Please describe:
Community service. Please write the type of community service:
Attend program. Please write what kind of program:
Probation. Please write the number of days of probation:



Time served. Please write the number of days in time served prior to sentencing:



Custody. Please write the number of days of custody:



Intermittent
custody. Please write the number of days in intermittent custody:



Other. Please specify:
Unknown15.19 code#sec4 15.20 Year 


Month 
Day 

15.21 What was the sentence: (Check all that apply.)
Absolute discharge
Conditional discharge and probation. Please write the number of days of probation:



Suspended sentence and probation. Please write the number of days of probation:



Conditional sentence. Please write the number of days:



Fine/Restitution. Please write the dollar amount of fine/restitution:



Personal services. Please describe:
Compensation order. Please describe:
Community service. Please write the type of community service:
Attend program. Please write what kind of program:
Probation. Please write the number of days of probation:



Time served. Please write the number of days in time served prior to sentencing:



Custody. Please write the number of days of custody:



Intermittent custody. Please write the number of days in intermittent custody:



Other. Please specify:
Unknown15.22 code#sec5 



15.23 Year 


Month 
Day 

15.24 What was the sentence: (Check all that apply.)
Absolute discharge
Conditional discharge and probation. Please write the number of days of probation:



Suspended sentence and probation. Please write the number of days of probation:



Conditional sentence. Please write the number of days:



Fine/Restitution. Please write the dollar amount of fine/restitution:



Personal services. Please describe:
Compensation order. Please describe:
Community service. Please write the type of community service:
Attend program. Please write what kind of program:
Probation. Please write the number of days of probation:



Time served. Please write the number of days in time served prior to sentencing:



Custody. Please write the number of days of custody:



Intermittent custody. Please write the number of days in intermittent custody:



Other. Please specify :
UnknownEnd of the coding sheet