Georgia Application For Sentence Review (gwinnette County)

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					       APPLICATION FOR SENTENCE REVIEW

                                                                        Indictment No.

                                                                                                                           Superior Court
(NAME)
                       VS
                STATE OF GEORGIA




The above named applicant hereby applies to the Superior Courts Sentence Review Panel of Georgia for review of the felony sentence(s)
imposed in the Superior Court of                                               County on                             , 20
wherein the sentence or consecutive sentences total twelve (12) years or more.

The Clerk will please forward a copy of the sentence(s) of the Court, the indictment(s), pre-sentence or post-sentence investigation made
by the Court or by the probation officer and a copy of the criminal record of the applicant.

Application for Review of Sentence is made pursuant to OCGA § 17-10-6.

Application may be filed by the defendant or attorney. Please indicate whether you are the

            ATTORNEY                    DEFENDANT

Please indicate below the name and address of the person filing this        Complete the information below concerning the defendant:
Application:
                                                                            State I.D. Number:

                                                                            Date of Birth:

                                                                            Social Security Number




DATE                                                                   SIGNATURE OF APPLICANT

                                 PLEASE RETURN THIS FORM TO THE SUPERIOR COURT
                           CLERK OF THE COUNTY IN WHICH THE DEFENDANT WAS SENTENCED




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