Impact Statement: Child VICTIM IMPACT STATEMENTDate Sent MM slash DD slash YYYY Victim's NameCommonwealth VS.CR #Prosecuting AttorneyAs the victim of a crime you have the right to offer a statement to the judge prior to the sentencing of the defendant. This form is provided to you for this purpose. Please address the impact that this crime has had on you and your family, but do not describe details of the crime itself. By law, a copy of this form must be given to defense counsel, if requested, prior to trial and it is thereby possible that the defendant will see it. If you have additional questions or need assistance, please call the Victim/Witness Department at (717) 771-9600. The completion of this statement is voluntary. Parents: If your child is unable to read, please read the instructions out loud to your child. While you may need to write the answers your child gives, please do not tell the your child what to say or draw. Remember that your child should only do this if he or she indicates an interest. 1. How do you feel about what happened to you? List all the different feelings you have about the crime.2. Are there activities that you do not do now either because you don’t want to or are not able to as a result of what happened to you?3. If you would like to, you can draw a picture on this page to tell the judge how you feel about what happened to you.Date MM slash DD slash YYYY
