IN THE CIRCUIT COURT OF THE STATE OF OREGON

FOR COUNTY

THE STATE OF OREGON,)

)

Plaintiff,)CASE NO.

)

v.)JUDGEMENT AND CONVICTION

)WITH CONCURRENT DEPARTMENT

)OF CORRECTIONS SENTENCE

)AND JUDGMENT UPON FINDING OF

)GUILTY EXCEPT FOR INSANITY AND

,)PLACEMENT UNDER PSYCHIATRIC SECURITY REVIEW BOARD

This matter came before the above entitled Court on , before the Honorable , Court Judge; defendant appearing in court in person and with his/her attorney, , and the State of Oregon appearing by , (Deputy) District Attorney for County; and

IT APPEARING TO THE COURT that prior hereto, the defendant entered a plea of not guilty to the charge(s) of ; and

IT FURTHER APPEARING TO THE COURT that the defendant has given notice of intent to rely on evidence of qualifying mental disorder as an affirmative defense on count _____ and that the defendant has given notice of intent to plead guilty on counts ______; and

IT FURTHER APPEARING TO THE COURT that based upon the report of , who is certified by the Oregon Health Authority to conduct such an evaluation, the stipulation of counsel, and the records and files herein; and the court being fully advised in the premises, finds the above named defendant able to understand the nature of the charge(s) against him/her and to assist and cooperate with counsel and participate in his defense; and

IT FURTHER APPEARING TO THE COURT that on , the matter came to trial before the court, the defendant having waived his right to trial by jury in writing; and the court having heard the evidence of the State and the defendant by stipulation , and being fully advised in the premises

THE COURT HEREBY FINDS:

(1) That the defendant stipulated to a finding of guilty by the court as to Count 1 – MANSLAUGHTER IN THE SECOND DEGREE; the defendant further stipulated that the evidence if presented would establish that the defendant is guilty of Count 1, beyond a reasonable doubt, and after hearing the argument of respective counsel, the court FINDS defendant GUILTY as charged on Count I.

It is ADJUDGED that on Count 1, defendant be committed to the custody of the Department of Corrections for 75 months with a period of post-prison supervision of ______years. This sentence is to be served concurrently with the disposition in Counts 2-4;

That the victim(s) of Count 1, , at does/does not desire notification of any Board of Parole and Post-Prison Supervision Hearing, escape or release from Department of Corrections.

(2)That the defendant, , committed the act alleged in Counts 2-4of the indictment constituting the crimesof MANSLAUGHTER IN THE SECOND DEGREE (2 COUNTS AND ASSAULT IN THE SECOND DEGREE; that these crimesare Tier I offenses;

That, based on the report of Dr., dated , that the defendant is affected by a qualifying mental disorder, to wit ______;

That as a result of qualifying mental disorder at the time of engaging in criminal conduct, the defendant lacked substantial capacity either to appreciate the criminality of the conduct or to conform his/her conduct to the requirements of law;

That the defendant would have been guilty of a felony during a criminal episode;

That because of the defendant’s qualifying mental disorder, he presents a substantial danger to others, requiring immediate commitment to a state mental hospital designated by the Oregon Health Authority, and is not a proper subject for conditional release at this time.

That the victim(s) of Counts 2-4, , at does/does not desire notification of any Psychiatric Security Review Board (PSRB) hearings, conditional release, discharge or escape of the defendant.

IT IS HEREBY ORDERED AND ADJUDGED that on Counts 2-4, the defendant is guilty except for insanity and placed under the jurisdiction of the PSRB for care, custody and treatment for a maximum period of time not to exceed 220 months;

IT IS FURTHER ORDERED AND ADJUDGED that the defendant be, and he hereby is initially committed to the custody of the state mental hospital designated by the Oregon Health Authority and that the Wasco County Sheriff shall immediately transport defendant to said hospital forthwith.

It is FURTHER ORDERED that in the event that the PSRB determines that the defendant is no longer subject to its jurisdiction or that defendant is appropriate for conditional release, the defendant shall be transferred immediately to the legal and physical custody of the Department of Corrections for the remainder of the term set out in Count 1 above.

IT IS SO ORDERED this day of , 20.

(Judge Name)

Court Judge

cc:

Oregon Psychiatric Security Review Board

610 SW Alder St. Ste 420

Portland, OR 97205

Phone: (503) 229-5596

Fax: (503) 224-0215

1 – JUDGMENT UPON FINDING OF GUILTY EXCEPT FOR INSANITY AND CONCURRENT SENTENCE UNDER DEPARTMENT OF CORRECTIONS

Revised 12/27/17