Disposition Form (Adult)

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DISPOSITION

NAME:_____________________________________

DATE:___________________

CASE #s:___________________

WHEREAS having considered the purpose and principles of sentence found in s. 718 to 718.2 of the Criminal Code;

AND having considered the circumstances of the offence and the personal circumstances of the offender;

AND having heard submissions of both Crown and defence counsel;

AND having heard the statement of the accused and the statement(s) of the victim(s) OR having been satisfied that the accused and victim(s) were afforded an opportunity to give statements relevant to sentencing;

I find that a fit and proper sentence for this offender is as follows:

CUSTODY

• ☐ You are sentenced to [a global period of] _______________ to be served in a ☐ provincial correctional facility / ☐ a federal institution.
• ☐ This sentence is to be served:
  • ☐ on a straight time basis
  • ☐ concurrently to any sentence you are already serving.
  • ☐ intermittently between the hours of _________ and __________, beginning on _________________
• ☐ SEE BELOW for CONDITIONAL SENTENCE ORDERS, INCLUDING TERMS AND CONDITIONS

• The sentence shall be broken down as follows:

Count #	Charge	Period of Custody	Concurrent or Consecutive

DISCHARGE/SUSPENDED SENTENCE

• ☐ you are granted a Absolute Discharge
• ☐ you are granted a Conditional Discharge, which will become absolute upon successful completion of the period of probation without any new criminal convictions arising.
• ☐ your sentence is suspended subject to the successful completion of the period of probation without any new criminal convictions arising.

PROBATION

Form of Order

You shall:

• ☐ for a period of ______________ beginning on the date of this order;

Terms and Conditions

Mandatory

...comply with the following terms and conditions:

• ⛝ keep the peace and be of good behaviour
• ⛝ appear before the court as and when directed;
• ⛝ notify the court, probation officer or supervisor, in advance, of any change of name, address, employment or occupation.

Optional

...And in addition you shall:

• ☐ report to probation services at _________________________ within ____________ days of from [today / date of expiration of your sentence of imprisonment] and thereafter when required, as directed by your probation officer or supervisor.
• ☐ remain within the province of Nova Scotia unless you receive written permission from your probation officer;
• ☐ not to take or consume alcohol or other intoxicating substances;
• ☐ not to take or consume a controlled substance as defined in the Controlled Drugs and Substances Act except in accordance with a medical prescription;
• ☐ not to own, possess or carry a weapon, ammunition or explosive substance;
• ☐ complete ___________ hours of community service work as directed by your probation officer by _____________;
• ☐ participate in the following treatment programs: ____________________________________________
• ☐ have no direct or indirect contact or communication with ______________________________________________________________________________________________________________________________________ except: ☐ (a) through a lawyer; ☐ (b) in accordance with a written separation agreement or court order for access to a child or children; ☐ (c) through ________________________________________________________________ for the purpose of access to a child or children; ☐ (d) incidental contact in an educational or treatment program or while at work; ☐ (e) ___________________________________________________________________________ ☐ (m) do not be on or within __________ meters of the premises known as: ____________________________________________________________________________________________________________________________ except ____________________________________________________________________________________ (n) ☐ make reasonable efforts to locate and maintain employment or an educational program as directed by your probation officer;

• ☐ attend for mental health assessment and counselling as directed by your probation officer;
• ☐ attend for substance abuse assessment and counseling as directed by your probation officer;
• ☐ attend for assessment and counseling in anger management as directed by your probation officer;
• ☐ attend for assessment and counseling in a violence intervention program as directed probation officer; ☐ (spousal or partner related)
• ☐ attend for gambling addiction assessment and counseling as directed by your probation officer;
• ☐ attend for assessment, counselling or a program as directed by your probation officer;
• ☐ participate in and co-operate with any assessment, counseling or program direct by your supervisor;
• ☐ not to associate with or be in the company of the following persons: _________________________________________________________________________________________________________________________________ except incidental contact in an educational or treatment program or while at work;
• ☐ make restitution through the Clerk of the Court on or before: ___________________________________________
• ☐ submit for urinalysis or other alcohol or controlled substance screening as directed by your probation officer;
• ☐ submit to electronic monitoring as directed by your probation officer;

Curfew

• ☐ remain in your residence from __________ until ___________the following day, seven days a week except under the following terms:
  • ☐ when at regularly scheduled employment, which your probation officer knows about, and travelling to and from that employment by a direct route;
  • ☐ when attending a regularly scheduled education program, which your probation officer knows about, or at a school or educational activity supervised by a principal or teacher, and travelling to and from the education program or the activity by a direct route;
  • ☐ when dealing with a medical emergency or in medical appointments involving you or a member of your household and traveling to and from it by a direct route;
  • ☐ when attending a scheduled appointment with your lawyer or a probation officer, and traveling to and from the appointment by a direct route;
  • ☐ when attending court at a scheduled appearance or under subpoena and traveling to and from court by a direct route;
  • ☐ when attending a counselling appointment, a treatment program or a meeting of Alcoholics Anonymous or narcotics anonymous, at the direction of war with the permission of your probation officer, and traveling to and from that appointment, program or meeting, via direct route;
  • ☐ when attending a regularly scheduled religious service;
  • ☐ when making application for employment or attending job interviews, Monday through Friday, between the hours of 9:00 a.m. and 5:00 p.m.;
  • ☐ when in a residential treatment program if your probation officer is told, in advance, where you will be and you agree that the facility can tell your probation officer if you are there, should your probation officer inquire;
  • ☐ with written approval of your probation officer given beforehand;

Compliance

• ☐ For the duration of the curfew, you must prove compliance with the curfew condition by presenting yourself at the entrance of your residence should a probation officer or a peace officer attend there to check compliance.

CONDITIONAL SENTENCE

• ☐ You are sentenced to imprisonment for a period of _______________. Whereas the Court is satisfied that should you remain in the community you will not endanger the safety of this community and is satisfied that such a sentence is consistent with the fundamental purpose and principles of sentencing. You shall serve this sentence in the community under the follwoign terms and conditions:

Mandatory Terms

• ⛝ keep the peace and be of good behaviour;
• ⛝ appear before the court when required to do so;
• ⛝ Report to a supervisor at ______________ on or before _______________ and then as directed thereafter;
• ⛝ Remain in the province of _____________________ unless written permission from the Sentence Supervisor is obtained
• ⛝ Notify promptly of any change in name address, employment or occupation.

Optional Terms

... and in addition, you shall:

• ☐ not take or consume alcohol or other intoxicating substances;
• ☐ not take or consume a controlled substance as defined in the Controlled Drugs and Substances Act except in accordance with a medical prescription;
• ☐ not own, possess or carry a weapon, ammunition or explosive substance;
• ☐ complete _______________ hours of community service work by _____________ as directed by your supervisor;
• ☐ participate in the following treatment programs: __________________________________________________________________________________________________________________________________________
• ☐ attend for mental health assessment and counselling as directed by your supervisor;
• ☐ attend for substance abuse assessment and counseling as directed by your supervisor;
• ☐ attend for assessment and counselling in anger management as directed by your supervisor;
• ☐ submit for urinalysis or other alcohol or controlled substance screening as directed by your supervisor;
• ☐ attend for assessment and counselling in a violence intervention program as directed; ☐ (spousal or partner related)
• ☐ attend for gambling addiction assessment and counselling as directed;
• ☐ attend for assessment, counseling or a program as directed by your supervisor;
• ☐ participate in and co-operate with any assessment, counseling or program as directed by your supervisor;
• ☐ not to associate with or be in the company of the following persons: _________________________________________________________________________________________________________________________ except incidental contact in an education or treatment program or while at work;
• ☐ have no direct or indirect contact or communication with ___________________________________________________________________________________________________________________________________ except: ☐ through a lawyer, ☐ in accordance with a written separation agreement or court order for access to a child or children; ☐ through __________________________________________________________________ for the purpose of access to a child or children, ☐ incidental contact in an education or treatment program or while at work; or * ☐ ______________________________________________________________________________

House Arrest / Curfew

• ☐ remain in your residence at all times beginning at _____________ on ______________ and ending on ___________, inclusive, except on the following terms:
• ☐ remain in your residence from __________________ until ___________________ the following day, seven days a week beginning on ___________________________ and ending on ___________, inclusive, except on the following terms:

Exceptions

• ☐ when at regularly scheduled employment, which your supervisor knows about, and travelling to and from that employment by a direct route;
• ☐ when attending a regularly scheduled education program, which your supervisor knows about, or at a school or educational activity supervised by a principal or teacher, and travelling to and from the education program or the activity by a direct route;
• ☐ when dealing with a medical emergency or medical appointments involving you or a member of your household and traveling to and from it by a direct route;
• ☐ when attending a scheduled appointment with your lawyer, your supervisor or a probation officer, and traveling to and from the appointment by a direct route;
• ☐ when attending court at a scheduled appearance or under subpoena, and traveling to and from court by a direct route;
• ☐ when attending a counselling appointment, a treatment program or a meeting of Alcoholics Anonymous or Narcotics Anonymous, at the direction of or with the permission of your supervisor, and traveling to and from that appointment, program or meeting, by a direct route;
• ☐ when attending a regularly scheduled religious service with permission of your supervisor;
• ☐ when making application for employment or attending job interviews, Monday through Friday between the hours of 8 a.m. and 5 p.m. with the permission of your supervisor;
• ☐ when in a residential treatment program if your supervisor is told, in advance, where you will be and you agree that the facility can tell your supervisor if you are there, should your supervisor inquire;
• ☐ for not more than ______________ hours per week, approved in advance by your supervisor, for the purpose of attending to personal needs;

Proof of Compliance

• ☐ Prove compliance with the curfew/house arrest conditions by presenting yourself at the entrance of your residence should your supervisor or a peace officer attend there to check compliance.

RESTITUTION ORDERS:

PROHIBITION ORDERS:

• ☐ You shall be subject to a
• ☐ You shall be subject to a driving prohibition order under s. 259 for a period of _____________ beginning ____________

FORFEITURE ORDERS:

DNA ORDERS:

SOIRA ORDERS: