Victim Impact Statement

Offender Name, DPS&C #*
Parole Hearing Date:*
MM slash DD slash YYYY
Victim Information:
Name*
Phone*
Address*
Email*

Victim Impact Statement
The submission of a victim impact statement is a voluntary right for victims of crime. The purpose of the victim impact statement is to provide parole panel members the opportunity to understand how the crime has affected you, your family, and those close to you.
Please describe the offense, and how it has affected you and your family.*
What was the emotional impact of this crime on you and your family.*
What was the physical impact of this crime on you and your family? (Note: This question should be utilized for personal/violent crimes).*
What was the financial impact of this crime on you and your family? (NOTE: Provide information about documenting losses for restitution and other financial/legal obligations such as child support).*
What, if any, was the spiritual impact of this crime on you and your family?*
What, (if anything) has changed in your life since the time the crime occurred and now?*
What do you want to happen now?*

Reentry Statement
The Reentry Statement will be considered by the parole panel only for the purpose of determining the offender’s parole conditions and not for the purpose of determining whether or not to grant parole.
Would you like to request any special conditions of parole supervisions that would restrict the offender’s proximity or contact with you and/or your family? If “yes”, please describe.
If community service is recommended as part of the offender’s return to the community, do you have a favorite charity or non-profit organization you’d like to recommend as a placement?
Is there any other information you would like to share with the Crime Victims Services Bureau or the Committee on Parole regarding the offense; how it affected you and your family; and any concerns you have if/when the offender is released to community supervision?
If you choose to submit a victim impact statement, please submit your written statement by U.S. Mail to Committee on Parole, Post Office Box 94304, Baton Rouge, LA 70804 or by e-mail to paroleboard@corrections.state.la.us. You may also contact the Crime Victims Services Bureau at 877-342-6110 for guidance in submitting a re-entry statement. So that we can ensure that your statement is included in the offender record, please include the offender’s name, DPS&C #, and the date of the hearing. It is also important that you include your contact information. It is essential that the statement is received at least 14 days in advance of the scheduled parole hearing. For further information that may be helpful, visit http://doc.la.gov/louisiana-board-of-pardons-and-parole/ or http://doc.la.gov/victim-services/ .
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.

Louisiana Department of Public Safety & Corrections Providing public safety for the state of Louisiana through corrections, reinvestment, and rehabilitation.
LA DPS&C

Submit Your Victim Impact and Reentry Statements

How to Submit

Digital Form: Guide for Victim Impact and Reentry Statements

Step 1 of 3

Victim Information:

Reentry Statement

Home / Public Programs & Resources / Victim Services

Submit Your Victim Impact and Reentry Statements

How to Submit

Digital Form: Guide for Victim Impact and Reentry Statements

Step 1 of 3

Victim Information:

Victim Impact Statement

Reentry Statement