Free cc219b.pmd - Michigan

Approved, SCAO

Original - Court 1st copy - Corrections 2nd copy - Corrections (for return)

3rd copy - Michigan State Police CJIC 4th copy - Defendant 5th copy - Prosecutor

STATE OF MICHIGAN JUDICIAL CIRCUIT COUNTY
ORI

JUDGMENT OF SENTENCE COMMITMENT TO DEPARTMENT OF CORRECTIONS

CASE NO.

Court address

Court telephone no.

MIPolice Report No.
Defendant name, address, and telephone no.

THE PEOPLE OF THE STATE OF MICHIGAN

v
CTN/TCN SID DOB

Prosecuting attorney's name

Bar no.

Defendant attorney's name

Bar no.

1. The defendant was found guilty on
CONVICTED BY DISMISSED BY* Count Plea* Court Jury

Date

of the crime(s) stated below.
CRIME CHARGE CODE(S) MCL citation/PACC Code

*For plea: insert "G" for guilty plea, "NC" for nolo contendere, or "MI" for guilty but mentally ill. For dismissal: insert "D" for dismissed by court or "NP" for dismissed by prosecutor/plaintiff.

2. The conviction is reportable to the Secretary of State under MCL 257.625(21)(b). Defendant's driver's license number 3. HIV testing and sex offender registration is completed. 4. The defendant has been fingerprinted according to MCL 28.243. IT IS ORDERED: 5. Probation is revoked. 6. Participating in a special alternative incarceration unit is prohibited. permitted. 7. The defendant is sentenced to custody of the Michigan Department of Corrections. This sentence shall be executed immediately.
Count

SENTENCE MINIMUM MAXIMUM DATE SENTENCE JAIL CREDIT Years Mos. Days Years Mos. Mos. Days DATE BEGINS

OTHER INFORMATION

8. Sentence(s) to be served consecutively to (If this item is not checked, the sentence is concurrent.) each other. case numbers 9. The defendant shall pay:
State Minimum Crime Victim Restitution Court Costs Attorney Fees Fine Other Costs Total

.

$ $ $ $ $ $ $ The due date for payment is . Fine, costs, and fees not paid within 56 days of the due date are subject to a 20% late penalty on the amount owed. 10. The concealed weapon board shall suspend for days permanently revoke the concealed weapon license, permit number , issued by County. 11. The defendant is subject to lifetime monitoring under MCL 780.520n. 12. Court recommendation:
Date Judge Bar no.

$

I certify that this is a correct and complete abstract from the original court records. The sheriff shall, without needless delay, deliver the defendant to the Michigan Department of Corrections at a place designated by the department.
(SEAL)
Deputy court clerk CC 219b (3/09) MCL 765.15(2), MCL 769.1k, MCL 769.16a, MCL 775.22, MCL 780.766, MCR 6.427

JUDGMENT OF SENTENCE, COMMITMENT TO DEPARTMENT OF CORRECTIONS