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Brody Hinz ff Semmes VICTIM IMPACT Perc sy een be 64 Saskatchewan oe STATEMENT D 7 Vietin's Name _£5 Codes naz. Police Service onice pane vee Li ___ ite Fie Numer Ths form maybe used in provide a desripon a the physinl or enstonal by youas the result of th tormmision of an uence wel sic edional pages if you need more spce ‘in, property dasiagso* eoonomi lorraine ssa desertion he impact ofthe afease on you. You ay ‘Your sateen! mus: nt ince: + ny steerent ahont he effence or the fender that sna elvan te ham or lass you sued + any unproven allegations: + By comenswbout any offence for which the offend was nt enol, © any vorplait about any ndividve, other than the cere, who vcs ives inthe investigation ce resection othe collins; ‘+ excep withthe cours pesove, an opinion or commendation sbout theses ‘You may reset detailed account ofthe impact the offen as had on you Life The fallow Information yor may wish fo izlude in you statement, You re ot rented to nce al Bmotonal impact Describe how te offence sae you emotionally. For example, think of your liftsisle and activities; ostons ar exams of informacion + your celatonships with ots such az your spouse, asiy and frends so your ability to work, send school or stl nd ‘owe Felngs, motions and resting as they relate fo the offence S <e a! Sec Awe Oe i Gusisaled eonfiseel, exying inks gelling pasecl of n 1) mo fo shay she ‘+ _ whonally skainoct Physical impact Desorie low the ofence ins afected you physically. Fur example think of + ongsing physicel ain discon, ines, string, difiguomeat or hysical imitation; + hospitalization ar singory you have had bacnse ofthe offen + este, physotnerapy or medication you have beon presided, + the nee foray Fither eaten’ or thé expectation tty Will eeive farther twetwents nd + any permanent or long-term dsabiiy ZT fied tk nario ao out in public 10 Mtoe laces Bcequan’s Loi Exel S wwe use ts Heonomic impact ibe how the oftence has a eed you Financially. or example, think of c= + the value of any property that was ios: or damages and the eost of repairs or replacement; + any oancial loss dc to missed time from works + the cost of any medical expenses, therapy or counsel + any cosis 0: Insses that ar not covered by insurnce, Please note that this is aol an application for earapensation or restitution Fears for security Deserbe any Fears yu heve for your sscurty or hat of you Family and frends Por exe hk of oncern With rset o onl withthe ode and spect conte: between thy offender and members of your Sail w lose rons rag, poem oF letter ‘You may ose this space to draw a picture er writes pen or tr iit wil lp you express the impact that he offence Has, onyou D7 1 wate ta present my statment in ent “Toth best of my knowledge, the information combined in this stein str Dueditis 19 day of Sooo 20 14 _.a__Hum PS, Signature of declarant : ee iz ¥ youcompee hi stent n bbl he isin, lene into nas why you dao nema fc co-chontin he icin Be o860A og 1_af uoas, 4O ‘nated See Sye«_erationaliy —_ Daedibs 14 dayof Saray 2019.9! Humboledd é Sts oat Ly seeqment Statement on Restitution ola Saskatchewan Comado, Posince of Smkaihesn, “Toh coun thai semencing nan of anew wa envied ‘wos discharge under setion 750 af the Oita Co ran offence wos at 214i Yom net seeking estiuon forthe Iogses sed damages sulereda he result of te cms ofthe offs, ey cha, ele i ees prion 1D Giptan seking estson inthe amount of forthe following fases and damages | sulferwdasa result ofthe eonmission af the ofience Bescon “cua oF sad tn vb cf tags ee te a af ess gt o A 2 A 2 s 4 § {irs athe moun of my losses nl damages mst be recy atertanabe bythe gor, Fu al purose lam reponse fr providing te sor wilh all cesta dceurents inet bil, ips aes, suppet of my lim or reson, eats dyer Signatnre of etarant {nekdeattevmmaon: Lacaion of nce Nowe of ivestaning police mguney and atest Plc nedenile umber —Penseindiss whether vietion is Undvidunl C1 Business ora sy ts business or agency provide your ie rumber andor cont pan Malling nduress: 7.0, Box Sheet uddress __ chy Prowine Insurance Coverage: she losdarngs insore? Ves FINo —It'yes amount of furan deus § ae ad phone norbereFnsuranoe companytsle, if you have been the victim ofa crime ‘The Vitims Serves Program lps vietns iavolved in the evn juve system in Saskatchewan by providing programs and services, IF you nocd help with your Visti Impact Stitemn ar Sltiement on Reston, conte ihe obceised vietim services program neses yor yu lol police servicer RCM detchne, ¢7 | For more informion and ts of poicehasedvictin sevies programe | | Wy have queaions aeration go to wor saskateheunn sa/igimervices or enact has been acdeved coal Toll fe: [88 286.6664 Tolle: |-888-285-6664 lo Regine: 306-757-3800 sn Regina: 306-787-0173 | null sotimssavicasgy a co Ens pation gosh