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Victim Impact Statement - Hillsborough County State Attorney Office

Victim Impact Statement - Hillsborough County State Attorney Office 2025

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The document is a Victim Impact Statement form used in the Hillsborough County Court system, designed for victims of crime to report their injuries, losses, and the impact of the crime on their lives. It includes sections for requesting restitution, detailing physical injuries, listing stolen or damaged property, documenting lost income, providing insurance information, sharing personal comments about the crime's effects, and making sentencing recommendations. The form must be notarized before submission.

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Click ‘Get Form’ to open the Victim Impact Statement in the editor.
Begin by entering your name in the 'Victim’s Name' field. If applicable, fill in the name of a parent, guardian, or next of kin.
In the 'RESTITUTION' section, indicate if you are requesting restitution. If yes, attach copies of relevant bills or receipts and enter the total amount requested.
For 'PHYSICAL INJURIES', answer whether you received medical treatment. If yes, provide details about your injuries and any psychological services received.
In 'PROPERTY STOLEN OR DAMAGED', list items that were stolen or damaged due to the crime along with their repair or replacement costs.
Document any 'LOST INCOME' by noting days missed from work and calculating total loss based on your rate of pay.
Complete the 'INSURANCE' section by providing details about any insurance coverage related to your injuries or losses.
Use the 'VICTIM COMMENTS' section to express how the crime has impacted you and your family.
Finally, make recommendations for sentencing in the designated area and ensure all sections are completed before signing.

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What are some examples of successful victim impact statements?

Many victims also find it helps provide some measure of closure to the ordeal the crime has caused. The victim impact statement assists the judge when he or she decides what sentence the defendant should receive.

What not to say in a victim impact statement?

Dont describe what you want to happen to the offender in prison. Please do not get descriptive about any harm you would like to see imposed. Dont put personal, identifying information in your letter and do not say it verbally in court.