2016 Louisiana Laws
Code of Criminal Procedure
CCRP 993 - Supplemental forms to be used
Art. 993. Supplemental forms to be used
"
SUPPLEMENTAL SHEET
____ Yes ____ No
ARRESTS THAT DID NOT RESULT IN CONVICTION
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Time expired for prosecution
_____/____/_______
(MM/DD/YYYY)
( ) Charge refused by DA - not prosecuted.
( ) Pre-trial Diversion Program.
( ) Charge dismissed
( ) Found not guilty/judgment of acquittal
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Time expired for prosecution
_____/____/_______
(MM/DD/YYYY)
( ) Charge refused by DA - not prosecuted.
( ) Pre-trial Diversion Program.
( ) Charge dismissed
( ) Found not guilty/judgment of acquittal
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Time expired for prosecution
_____/____/_______
(MM/DD/YYYY)
( ) Charge refused by DA - not prosecuted.
( ) Pre-trial Diversion Program.
( ) Charge dismissed
( ) Found not guilty/judgment of acquittal
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Time expired for prosecution
_____/____/_______
(MM/DD/YYYY)
( ) Charge refused by DA - not prosecuted.
( ) Pre-trial Diversion Program.
( ) Charge dismissed
( ) Found not guilty/judgment of acquittal
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Time expired for prosecution
_____/____/_______
(MM/DD/YYYY)
( ) Charge refused by DA - not prosecuted.
( ) Pre-trial Diversion Program.
( ) Charge dismissed
( ) Found not guilty/judgment of acquittal
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Time expired for prosecution
_____/____/_______
(MM/DD/YYYY)
( ) Charge refused by DA - not prosecuted.
( ) Pre-trial Diversion Program.
( ) Charge dismissed
( ) Found not guilty/judgment of acquittal
SUPPLEMENTAL SHEET
____ Yes ____ No
MISDEMEANOR CONVICTIONS
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 894(B)
( ) More than 5 years have passed
since completion of sentence.
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 894(B)
( ) More than 5 years have passed
since completion of sentence.
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 894(B)
( ) More than 5 years have passed
since completion of sentence.
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 894(B)
( ) More than 5 years have passed
since completion of sentence.
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 894(B)
( ) More than 5 years have passed
since completion of sentence.
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 894(B)
( ) More than 5 years have passed
since completion of sentence.
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 894(B)
( ) More than 5 years have passed
since completion of sentence.
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 894(B)
( ) More than 5 years have passed
since completion of sentence.
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 894(B)
( ) More than 5 years have passed
since completion of sentence.
SUPPLEMENTAL SHEET
____ Yes ____ No
FELONY CONVICTIONS
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 893(E)
( ) More than 10 years have passed
since completion of sentence
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 893(E)
( ) More than 10 years have passed
since completion of sentence
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 893(E)
( ) More than 10 years have passed
since completion of sentence
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
since completion of sentence
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 893(E)
( ) More than 10 years have passed
since completion of sentence
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 893(E)
( ) More than 10 years have passed
since completion of sentence
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 893(E)
( ) More than 10 years have passed
since completion of sentence
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 893(E)
( ) More than 10 years have passed
since completion of sentence
ITEM NO.
La. Rev. Stat. Ann.
§ _______ : ________
Name of the offense
_________________
( ) Conviction set aside/dismissed
_____/____/_______
(MM/DD/YYYY)
pursuant to C.Cr.P. Art. 893(E)
( ) More than 10 years have passed
since completion of sentence
"
Acts 2014, No. 145, §1.
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