Judgment Imprisonment

							        IN THE IOWA DISTRICT COURT IN AND FOR BUENA VISTA COUNTY

STATE OF IOWA,                                                   No.
                       Plaintiff,

v.                                                 JUDGMENT AND SENTENCE
                                                    FELONY - IMPRISONMENT
,
                       Defendant.


       On this          day of                            , 20     , this matter comes on
for sentencing. The State appears by Assistant Buena Vista County Attorney Dave
Patton / Liz LaPole / Kiyoko Balk / Israel Kodiaga; defendant appears in person and with
attorney ________________________________. The Court has determined that there
is a factual basis for accepting the defendant's plea of guilty and the Court does accept
the plea. Defendant, having been found guilty, shows no legal cause why judgment
should not be entered and none appears on the record.

It is the Court's JUDGMENT that defendant is guilty of the crime of
_________________________________________, in violation of Iowa Code
Section(s) ____________________________, and defendant is SENTENCED under
Iowa Code Section(s) 902.9, 903.1 and __________________:

     A. and is committed to the custody of the Director, Department of Corrections for a
        term not to exceed                            years, with credit for ______ days
        previously served in the Buena Vista County Jail while unable to furnish bail.

     B. and is ordered to pay a fine of $            and surcharges of $___________.

Pursuant to Section 901.5 of the Iowa Code, the defendant is advised that the term of
incarceration may be reduced from the maximum sentence because of statutory earned
time, work credits, and program credits, and that the defendant may be eligible for
parole before the sentence is discharged. The Iowa Medical & Classification Center,
Oakdale, Iowa, is designated as the reception center to which defendant shall be
delivered by the Sheriff. Mittimus shall issue forthwith.

IT IS FURTHER ORDERED:

     Pursuant to Iowa Code §124.413, that defendant shall serve not less than one
     third of the maximum indeterminate sentence as a mandatory minimum term of
     incarceration.
____ Pursuant to Iowa Code §81.2, Iowa Code §81.4, and Iowa Code §901.5 (8A), the
     defendant shall submit a DNA sample for DNA profiling.
     Defendant shall make restitution payments as follows:
____ (a)   Name of Victim                                             Amount




____ (b) All court costs as calculated by the clerk and assessed in accordance with
Iowa law.
____ (c) Pursuant to Iowa Code Section 815.9(5), if the defendant is receiving court
       appointed legal assistance, the court finds upon inquiry, review of the case file
       and any other information provided by the parties, the defendant has the
       reasonable ability to pay restitution of fees and costs in the amount approved by
       the State Public Defender or $_______ whichever is less, and therefore the
       defendant is ordered to pay restitution, through the Clerk of this Court, for Court-
       appointed attorney fees as approved by the Court.

____ Report to the ________________County Sheriff for fingerprinting within 24
     hours.
____ Abide by the separate No Contact Order issued herein.
____ Pay a $125.00 law enforcement initiative surcharge.
____ Pay to the Sheriff of Buena Vista County, Iowa for the amount of the Sheriff’s
     Room and Board Reimbursement Claim, if any, that is hereafter filed, provided
     that the amount of restitution for such claim shall not exceed $55.00 for each day
     incarcerated and the amount of the Sheriff’s medical aid Reimbursement Claim, if
     any, that is hereafter filed.

In determining the sentence imposed in this matter, the Court has considered:

___    the defendant’s characteristics
___    the defendant’s family and financial circumstances
___    the defendant’s criminal record and social history
___    the circumstances of the offense
___    the harm to the victim, the victim’s family and the community
___    the plea agreement
___    mitigating circumstances:___________________________________________.
___    other factors: ____________________________________________________.

Having considered these factors, the Court has determined that the sentence imposed
will provide maximum opportunity for the rehabilitation of the defendant and for the
protection of the community from further offenses by the defendant and others.

        Pursuant to Rule 2.23(3)e, I.R.Cr.P., the defendant is advised of the statutory
right to appeal and the right of a person who is unable to pay the costs of appeal to
apply to the Court for the appointment of counsel and the furnishing of a transcript of the
evidence.
___   Pursuant to Iowa Code Section 811.1(2), defendant is remitted to custody without
      bond.
___   Defendant's appeal bond is fixed at $_____________.
___   Defendant’s appearance bond is released, and surety is exonerated.
      Defendant's appeal bond is fixed at $ _______________.

      IT IS FURTHER ORDERED that the law enforcement agency in possession of
any controlled substances seized from defendant shall cause those substances to be
destroyed on a date not less than sixty (60) days from the date of this order.




___ Contested     _____ Uncontested             ________________________________
                                                Judge, Third Judicial District


Copies to:
             Prosecuting Attorney               ____ Dept. of Correctional Services
             Defendant                               Sheriff
             Defense Counsel                         State Court Administrator


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