The Case Stella is a 42-year-old married mother of two. She works as an occupational therapist at a private nursing home. She is a respected member of the local community and is

TEXAS DEPARTMENT OF CRIMINAL JUSTICE

COMMUNITY JUSTICE ASSISTANCE DIVISION

PRE/POST SENTENCE INVESTIGATION REPORT

GENERAL INSTRUCTIONS: Pursuant to provisions of Art. 42.12 Sec. 9, a presentence investigation report shall be completed prior to the imposition of sentence by the court. Type or print all requested information. If the information is not available at the time the report is prepared, please state "not available" in the space provided. The source of information for each section should be reflected in the appropriate space. Additional comments and/or source documents for any section may be attached to this report, as local jurisdictions dictate.

DISP:	CS:	CS REV: Y N	PEN:
SAFPF:	JAIL:
Date PSI	Sentence
Completed:	Begin date:

I. COURT/LEGAL INFORMATION: Report information regarding the court of original jurisdiction and identification of attorneys assigned to the case.

County	ID	Sentencing Judge		Court
Prosecutor	Defense Counsel

(Last) (First) (MI) (Last) (First) (MI)

Source of information: COURT RECORD/DISTRICT ATORNEYS FILE

II. DEFENDANT INFORMATION: Provide demographic and/or other identifying information on the defendant in this section.

Cause #:	TRN #:	TRS

Name	aka (if known)
(Last) (First) (Middle Name)	(Last) (First) (Middle Name)

Current Address	Permanent Address
Phone #	Phone #

Age	Gender	Martial Status
DOB	Ethnicity	No. of Dependents

Place of Birth:	Citizenship:
(City) (State-Country)

Alien #:	Alien Status:	INS notified: Yes	No
SSAN:	Driver's License:	DPS/SID No.:
FBI No.:	TDCJ-ID #:	Other:

Source of information: INTERVIEW/NCIC/TCIC/COURT RECORDS

III. CURRENT OFFENSE: Provide information relative to the circumstances of the primary offense. A copy of the offense report may be attached. If the report is not attached, briefly describe the offense.

Offense

Offense Date

Arrest Date

Circumstance: SEE ATTACHED REPORT

Weapon used yes no If yes, type:

Page 2 Defendant's Name:

Cause No.:

*Guilt acknowledged

*Guilt minimized

*Declined to discuss

Source of information: INTERVIEW

*Optional Fields

IV. CUSTODIAL INFORMATION: Report whether the defendant is currently under correctional supervision.

Detainers/ County/

Pending Charges State

Source of information: COURT RECORD/JAIL RECORDS

V. CRIMINAL HISTORY: Report both juvenile and adult criminal histories on the defendant. If available, attach either a DPS, FBI rap sheet or NCIC-TCIC report and answer the following questions:

A. JUVENILE: Criminal Record ________ yes ________ no ________ unavailable

If Yes, Number of probations ________ Number of adjudications ________ Number of arrests ________

Source of information: INTERVIEW

B. ADULT: Criminal Record ________ yes ________ no ________ unavailable

Indicate the number of incidences regarding the defendant in the appropriate box(es):

	Arrests	Pretrial Intervention	Conviction(s)	Community Supervision(s)	Intermediate Sanction(s)	Community Supervision Revocation(s)	Parole/MS	Parole/MS Revocation(s)
Felony
Misdemeanor

Previous incarceration(s):

Jail: ______ yes ______ no; # ______; Charge(s) ________________________________________________________

Prison: ______ yes ______ no; # ______; Charge(s) ________________________________________________________

State Jail: ______ yes ______ no; # ______; Charge(s) ________________________________________________________

SAFPF : ______ yes ______ no; # ______; Charge(s) ________________________________________________________

Source of information: NCIC/TCIC INTERVIEW

C. STATUS AT TIME OF OFFENSE:

____________ Previous criminal history County/State ____________

____________ No Previous criminal history County/State ____________

____________ Bond Supervision County/State ____________

____________ Community Supervision County/State ____________

____________ Parole/Mandatory supervision County/State ____________

Age at 1st conviction: ________

Current gang affiliation: ________ yes ________ no If yes, name: ____________________

Past gang affiliation: ________ yes ________ no If yes, name: ____________________

Suspected gang affiliation ________ yes ________ no If yes, name of city/state: ____________________

Reason(s)

Source of information: COURT RECORD/INTERVIEW/NCIC-TCIC

Page 3 Defendant's Name:

Cause No.:

VI. VICTIM INFORMATION: If an offense report is attached, please respond to the questions pertaining to restitution only. If no offense report is attached, please answer all questions in this section. If there were no direct victims or property loss associated with the offense, then skip the remaining questions in this section.

Victim(s) associated with offense: ________ yes ________ no If yes, # __________________________________________________________

Relationship to victim:______________________________________________________________________________________________

Victim(s) age at time of offense: ______________________________________________________________________ (Sex Offense only)

Type of injury suffered/property loss:__________________________________________________________________________________

Restitution: Amount Claimed: $ _____________________________________________________________________________________

Source of information: DISTRICT ATTORNEYS FILE/OFFENSE REPORT

VII. SOCIAL HISTORY: Provide information regarding the defendants status.

A. HEALTH STATUS:

Has psychological evaluation of the defendant been prepared? ________yes ________ no If yes, attach.

Has the defendant ever been treated at a psychiatric hospital ________yes ________ no If yes, location : __________________

Has the defendant ever been treated at an MHMR facility? ________yes ________ no If yes, location : __________________

Does the defendant presently have a physical or medical or mental impairment? ________yes ________ no

If yes specify:____________________________________________________________________________________________________

Is the defendant currently taking any medications, including psychotropic? ________yes ________ no

If yes please list:__________________________________________________________________________________________________

Has the defendant ever attempted suicide? ________yes ________ no If yes date of last attempt:_________________

B. EDUCATIONAL STATUS: _____________________ Highest grade completed:

High school diploma: ________ yes ________ no Special classes: ________ yes ________ no

GED: ________ yes ________ no Some College: ________ yes ________ no

Vocational training: ________ yes ________ no College graduate: ________ yes ________ no

Type: ___________________________________ Job Skills:_________________________________

Provide information regarding any educational/psychological test(s) administered and the results:

Test: _______________________________ Results: ______________________________

_______________________________ ______________________________

_______________________________ ______________________________

_______________________________ ______________________________

Principal Language: _____________________________________ Secondary Language: ______________________________________

Does the defendant appear to be literate? ________ yes ________ no _______ yes ________ no

Source of information: INTERVIEW

Page 4 Defendant's Name:

Cause No.:

C. EMPLOYMENT STATUS: ________ Employed ________ Unemployed

If Unemployed ___________________ length; Amount of Income ___________________________

Source of Income ____________________________

Answer the following:

Current Employer:

Name:	Job Type:
Address:	Status:
	Date of employment:
Phone #	Amount of Income:

Reason for leaving ______________________________________________________________________________________

Is the defendant paying child support? ________ Yes ________ No

Source of information: INTERVIEW

VIII. SUBSTANCE ABUSE: Provide information regarding the defendant's reported use of drugs. Indicate the type and frequency of drug(s) used by placing an "X" in the appropriate space.

		Daily	Weekly	Monthly	Occasionally	Age first Used	Date Last Used	Denied Use
01	Alcohol/Beer
How many drinks – shots or beers, do you have in one sitting?	1-4 drinks	5-8	9 or more
02	Cocaine
03	Crack
04	Heroin
05	Marijuana
06	Amphet/Methamphetamines
07	LSD
08	PCP
09	Inhalants
10	Other Drugs:

Substance Abuse screening/evaluation (SASSI, ASI, etc): ________ Yes ________ No

If yes, tool and score:

Were any of the drugs noted above taken intravenously?: ________ Yes ________ No

Indicate the type and number of incidents of drug counseling or treatment received:

________ DWI education ________ AA/NA, etc.

________ Individual counseling ________ Drug education classes

________ Out-patient group counseling ________ Residential treatment

Was the defendant under the influence of drugs or alcohol at the time the offense was committed?: ________ Yes ________ No

Did the defendant commit the offense in order to obtain funds for the purchase of drugs or alcohol? ________ Yes ________ No

Source of information: INTERVIEW/JAIL RECORDS

Page 5 Defendant's Name:

Cause No.:

IX. SUPERVISION PLAN: The programs/supervision types identified by an "X" are available to the courts for this individual. The department may attach its individual plan if the items outlined below are addressed.

PROGRAMS COMMUNITY SUPERVISION TYPES

	Alcohol/Drugs Education		Pretrial Intervention/Supervision
	Alcohol/Drug Treatment		Deferred Adjudication
	Alcohol/Drug Evaluation		Regular Community Supervision
	Urinalysis		DWI Community Supervision
	Adult Basic Education (ABE)		Shock Community Supervision
	GED		State Jail Felony
	English as a second Language ESL	X	All Program Available
	Community Service Restitution (CSR)
	DWI School/Drug School
	Victim Impact Panel
	Vocational Intervention Program
	Life Skills Training
	Intensive Supervision Program
	Electronic Monitoring
	CCF
	Restitution of $
	Specialized Caseload; (specify type)
	Surveillance
	Employment
	Jail
	Sex Offender Counseling
	Other; (specify)

Legal Requirements:

	Ignition Interlock (per T.C.C.P. Article 42.12, Section 13(i)
	Sex Offender Registration (per T.C.C.P. Article 42.12, Section 11e)

Respectfully Submitted,

Supervision Officer Date	Telephone

Assisting Date

Page 6 Defendant's Name:

Cause No.:

X. NARRATIVE (Optional) A. EVALUATION/SUMMATION: B. RECOMMENDED TREATMENT PLAN:

STATE JAIL ONLY

SJF:�

(SJ UP FRONT)�

�

Cumulative with ID sentence? ______________

Concurrent with ID sentence? _______________

Special Medical Needs: ____________________

Release Type

Status In Jail

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