STATIC-99 – TALLY SHEET
Subject Name: ____________________________________________
Place of Scoring: __________________________________________
Date of Scoring: ____________
Question
Number
1
2

3
4
5

Risk Factor
Young
Ever Lived With

Index non-sexual violence Any Convictions?
Prior non-sexual violence Any Convictions?
Prior Sex Offences

8

Prior sentencing dates
(excluding index)
Any convictions for non-contact
sex offences
Any Unrelated Victims

9

Any Stranger Victims

10

Any Male Victims

6
7

Name of Assessor: ___________
Codes

Score

Aged 25 or older
Aged 18 – 24.99
Ever lived with lover for
at least two years?
Yes
No
No
Yes
No
Yes
Charges
Convictions

0
1

None
1-2
3-5
6+
3 or less
4 or more
No
Yes
No
Yes
No
Yes
No
Yes

0
1
2
3
0
1
0
1
0
1
0
1
0
1

None
1
2-3
4+

0
1
0
1
0
1

Add up scores from

Total Score individual risk
factors

Suggested Nominal Risk Categories

POINTS
0,1
2,3
4,5
6+

Risk Category
Low
Moderate-Low
Moderate-High
High