For / No.
Plaintiff,
vs.
Defendant. / Judgment and Sentence for:
1) Driving Under The Influence
Physical Control
2) Reckless Driving (RCW 46.61.500(3)
Negligent Driving - 1st Degree
(RCW 46.61.5249(4))
3) ______
(DUIJS)
The defendant is adjudged guilty based upon a guilty plea, jury verdict, or bench trial. The court verified the defendant’s criminal history and driving record and made findings as follows: (check all that apply):
GY Passenger under age 16, BAC _____, No Test, Refusal, Drug related, THC_____,
Non-alcohol related, CDL
Vehicle Information: Hazmat vehicle, Commercial vehicle, 16 Passenger vehicle, and ______
______;
therefore, the defendant is sentenced as follows:
Sentence is suspended for a period of months/years on the following conditions:
Count 1) ____ days of jail and suspends____ days; and a fine of $______with $ ______suspended
Count 2) ____ days of jail and suspends____ days; and a fine of $______with $ ______suspended
Jail: Serve a total of ______days in jail with credit for ______days served, and
serve a total of ______days of electronic home monitoring with credit for ______days served.
other alternative means of confinement: ______.
Jail sentences are concurrent/consecutive with all other commitments ______.
Pay: fine of $______Alcohol violator fee DUC $______
assessments $______criminal traffic fee $______
costs $______probation/monitoring fee $______
bench warrant fee $______booking fee $______
jail recoupment fee $______public defender recoupment $______
other ______$ criminal conviction fee $
Passenger under 16 fine $
DUI emergency response reimbursement to (agency): ______$
restitution to: $
(All payments shall be made through the clerk of this court, including restitution.) Total: $______
$ ______of this total is converted to ______hours of community restitution (service) which must be completed by ______. Proof of completion shall be provided to the court/probation department.
Mandatory Conditions of Sentence - DUI/Physical Control
(a) The defendant shall not drive a motor vehicle without a valid license and proof of liability insurance or other financial responsibility insurance. (b) The defendant shall not drive or be in physical control of a motor vehicle with an alcohol concentration of .08 or more or a THC concentration of 5.00 nanograms per milliliter of whole blood or higher, within two hours after driving. (c) The defendant shall submit to a breath or blood alcohol test upon the reasonable request of a law enforcement officer. If you violate (a), (b), or (c) within this state, the court shall order you confined for no less than 30 days and your driving privilege will be suspended for 30 days.
No criminal violations of law or alcohol related infractions.
Comply with the rules and requirements of the Department of Licensing regarding the installation and use of a functioning ignition interlock device.
Comply with the requirement to install an ignition interlock device for 6 months in addition to any other ignition interlock device requirements imposed by the Department of Licensing or the court. (Passenger under 16, RCW 46.61.5055(6).)
The court has ordered the defendant to refrain from consuming any alcohol. The defendant must comply with alcohol monitoring as authorized by law. The defendant shall pay the cost of monitoring. The cost of monitoring shall be paid by ______. (RCW 46.61.5055(5)).
Conditions of Sentence – Reckless Driving/Negligent Driving – 1st Degree
(a) The defendant shall not drive a motor vehicle without a valid license and proof of liability insurance or other financial responsibility. (b) The defendant shall not drive or be in physical control of a motor vehicle with an alcohol concentration of .08 or more or a THC concentration of 5.00 nanograms per milliliter of whole blood or higher, within two hours after driving.
No criminal violations of law or alcohol related infractions.
Comply with mandatory ignition interlock device requirements as imposed by the Department of Licensing.
Additional Conditions of Sentence - Discretionary Ignition Interlock - RCW 46.20.720(1)
Comply with discretionary ignition interlock device requirements:
For a period of ______years following the period of driver’s license suspension, revocation, or denial, drive only a motor vehicle equipped with a functioning ignition interlock device.
From ______(date) to ______(date), do not drive any motor vehicle unless it is equipped with an ignition interlock device (this does not authorize you to drive without a valid license).
Unless otherwise stated, the calibration level for any ignition interlock requirement imposed under this order shall be .025% ______.
“Employer exemption:” When the defendant provides an employer affidavit to the Department of Licensing, this order shall not apply to vehicles owned, leased, or rented by defendant’s employer or to those vehicles whose care and/or maintenance is the temporary responsibility of the employer and driven at the direction of the defendant’s employer as a requirement of employment during working hours. Except that, the employer exemption does not apply for the first ______days after the ignition interlock device has been installed; or when the employer’s vehicle is assigned exclusively to the defendant and used solely to commute to and from employment.
Additional Conditions of Sentence
(If available, effective January 1, 2014) Serve a 6-month period of 24/7 Sobriety Program monitoring (1 prior: alternative to EHM; 2 or 3 priors: mandatory, RCW 46.61.5055(2) and(3). Laws of 2013, 2d Spec. Sess, ch. 35, §§ 13, 23 - 33.)
Probation for ______months. Supervised probation for ______months with probation department and abide by all rules and regulations of probation department. Pay a pre-sentence fee and a monthly probation fee as set by the probation department.
Obtain an alcohol/drug evaluation expanded alcohol assessment from a Washington State-approved agency and file a copy of the evaluation/assessment within ______days. Begin any recommended/ appropriate treatment or education within ______days and file proof of timely enrollment and completion.
Begin the following within ______days, complete within ______days, and file proof of timely enrollment and completion: DUI Victim’s Panel Alcohol/Drug Information School One Year Alcohol/Drug Treatment Two Year Alcohol/Drug Treatment Alcohol/Drug Treatment for a period of ______Driver Improvement School Other ______.
Use no alcoholic beverages or non-prescribed controlled drugs.
Attend Alcoholics Anonymous Narcotics Anonymous Other self-help program (______) meetings _____ times a week for _____ months or as recommended by treatment provider.
Other: ______.
Return for a review hearing: . Bail or Bond is Exonerated Forfeited.
Dated:
I have read the rights, conditions, and warnings.
Defendant’s Signature Date of Birth Judge/Court Commissioner/Pro Tem
Prosecuting Attorney WSBA No.Defendant’s Address and Telephone / Defense Attorney WSBA No.
Written Waiver of Counsel is filed.
DUI Judgment and Sentence Form (DUIJS) - Page 1 of 2
CrRLJ 07.0100 (09/2013) CrRLJ 7.2, 7.3; RCW 46.20.720, 46.61.5055