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have for your security or that of your family and friends. For example, think of:
- to contact with the offender; and 
mbers of your family or close friends-

Lumujuu 3
a . to contact between the offender and me

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Dramng, poem 0r letter 
x?ou myuse this space to help you express the impact that the offence has had
on you.

draw a picture or write a poem or letter if it will

 

 

 

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cl had tilvo past billet sons on the ?rb?cb 3113,33,}

aw I?Leie 5?1. airmen; and depression since this event. I am not able to sleep
.-.. ingi?j 1(1va lilw mien! time beln'g In public due to the fear of seeing someone I know or

lil' 18131111-3 lie; . ilhave been going to a physiologist, group therapy sessions, and
33'13i'1ceuib I'have a fear of being on the highway, i am ?ooded with anxiety and sadness
?131 See-a bus or a semi-truck

@1315 year old twins who had special connections with both boys that we had living
i- V'a? at sons and it has been horrendous trying to help them through this and

1131133- ?erehe never had Issues before. I feel like the depression has stolen my ability to be

- 17373151 3 19.. .d me to be at times. Our son has expressed that it is so hard to see me crying and

. ?iaeshmg out with his behaviour In a way I have never seen before. They UP to
5:31 older brother and he was very active in their lives setting a strong example for

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For court use only

Government VICTIM IMPACT Information Numbcr

of

A Saskatchewan
., 
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Victim's Name Attrition Chratwnw" 1 Police Service 
Olfence DateO 4/06/38 Offence Location Magi/Edam Incident?file Number 2098- 44?5'36'l'3 

or emotional harm, property damage or economic loss suffered

This form may be used to provide a description of the physical .
by you as the result ofthc commission of an offence, as wet! as a description of the Impact ol'lhe offence on you. You may

attach additional pages if you need more Space.

 

 

 

 

 

Your statement must nor include:
any statement about the offence or the offender that is not relevant to the harm or loss you suffered.

0 any unproven allegations:
. any comments about any offence for which the otTender was not convicted: . . . 
- any complaint about any individual, other than the offender, who was involved In the investigation or prosecution of the

offence; or
- except with the court's approval, an opinion or recommendation about the sentence.
You may present a detailed account of the impact the offence has had on your life. The following sections are examples of
information you may wish to include in your statement. You are not required to include all of this Information.

Emotional impact
Describe how the offence has a?'octed you emotionally. For example, think of:
- your lifestyle and activities;
0 your relationships with others such as your spouse, family and friends;
. your ability to work, attend school or study; and
our feelings, emotions and reactions as they relate to the offence.

fame See, ail?Edited

 

 

 

 

 

Physical impact
Descn'be how the offence has affected you physically. For example, think of:
- ongoing physical pain, discomfort, illness, scarring, dis?gurement or physical limitations;
- hospitalization or surgery you have had because ofthe offence;
0 treatment, physiotherapy or medication you have been prescribed;
. the need for any further treatment or the expectation that you will receive further treatment; and

- any permanent or long?term disability.

 

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