R84 a Final

12/01/2020

OMB 1110-0051 

R-84 (a) 

 

1) Please provide a final disposition and the (*enter document type) 

*Staff will choose from the following depending on which is applicable for the specific state:  Sentencing Order, Index Card, Case Action Summary, Judgments, Judgment and Sentence, Judgment and Commitment Order, Judicial Confession, Criminal Information, Complaint, Bill of Information, Minute Order, Register of Actions, Official Court Disposition Record, Sentencing or Disposition Order, Disposition and Sentencing, Sentencing Accusation, Certificate/Judgment of Conviction, Judgment Entry, Criminal Complaint/Affidavit, Journal Entry, Judge’s Docket, Criminal Court Docket or Case Jacket, Final Court Minutes, Information of Case, Commitment to Jail, Order of Judgment, Plea Agreement/Factual Basis, Court Paper with Narrative, Disposition Report, Certificate of Disposition, Disposition Sheet, Criminal Warrant, Arrest Card, or Record of Court Martial Conviction. 

2)  Please provide the level or degree of felony or misdemeanor (felony, misdemeanor, summary, violation) and degree of conviction (felony 1st degree, misdemeanor 2nd). 

  

3)  Please provide a copy of the police/incident report with full narrative.  If applicable, please provide any associated/referenced reports.  

 

4)  If case is still pending, please advise if the subject is under indictment/information for a felony or misdemeanor with a maximum punishment that exceeds two years.  If under indictment or information, please provide the date the subject was placed under indictment or information. 

5)  Please provide the next court date. 

 

6)  Please provide the specific statute/subsection of conviction.  

7)  Please provide the sentence with the completion date.  

9)  If convicted, please provide the convicting dollar amount if applicable. 

10)  Was a pardon, restoration of rights, or set aside granted?  

11)  Please submit all supporting documentation regarding this individual along with your agency’s response.