FORM 1 - GENERAL MATRIX FORM 3 - SEX OFFENDER MATRIX
CRIMINAL HISTORY ASSESSMENT

PRIOR FELONY CONVICTIONS	None One Two Three More than three
(SEPERATE CRIMINAL CONVICTIONS)
PRIOR MISDEMEANOR CONVICTIONS	None One Two to Four Five to Seven More than seven
(SEPERATE CRIMINAL CONVICTIONS) (INCLUDES DUI & RECKLESS) (EXCLUDES OTHER TRAFFIC)
PRIOR JUVENILE ADJUDICATIONS	None One Two to Four More than four Secure placement
(ADJUDICATIONS FOR OFFENSES THAT WOULD HAVE BEEN FELONIES IF  COMMITTED BY AN ADULT) (THREE MISDEMEANOR ADJUDICATIONS  EQUAL ONE FELONY ADJUDICATION)

SUPERVISION HISTORY	No prior supervision Prior supervision Prior residential placement Prior revocation Act occurred under current supervision or pre-trial release
(ADULT OR JUVENILE)
SUPERVISION RISK	No escapes or abscondings Failure to report (Active offense) or outstanding warrant Absconded from supervision Absconded from Residential Program Escaped from confinement
(ADULT OR JUVENILE)

VIOLENCE HISTORY	None Misdemeanor 3rd Degree Felony 2nd Degree Felony 1st Degree Felony
(PRIOR JUVENILE OR ADULT CONVICTION FOR AN OFFENSE  WHICH INCLUDES USE OF A WEAPON, PHYSICAL FORCE,  THREAT OF FORCE, OR SEXUAL ABUSE)
WEAPONS USE IN CURRENT OFFENSE	None Constructive Possession Actual possession Displayed or Brandished Actual use Injury caused
(ONLY WHEN CURRENT CONVICTION DOES NOT REFLECT  WEAPON USE OR WHEN STATUTORY ENHANCEMENT IS  NOT INVOLVED)

FORM 1 - GENERAL MATRIX FORM 3 - SEX OFFENDER MATRIX
CRIMINAL HISTORY ASSESSMENT

FORM 1 - GENERAL MATRIX FORM 3 - SEX OFFENDER MATRIX
CRIMINAL HISTORY ASSESSMENT

FORM 1 - GENERAL MATRIX FORM 3 - SEX OFFENDER MATRIX
CRIMINAL HISTORY ASSESSMENT

NUMBER OF PRIOR VICTIMS	No prior victims One prior victim More than one prior victim
(PRIOR SEX OFFENSE VICTIMS, NOT INCLUDING PRESENT VICTIM)
TIME RANGE	One-Time incident Within one year Within two years Two years or over
(NUMBER OF YEARS OFFENDER HAS BEEN OFFENDING SEXUALLY)

FORM 1 - GENERAL MATRIX
CRIMINAL HISTORY ASSESSMENT

TOTAL SCORE: _____________0

CRIMINAL HISTORY ROW V 16 + IV 12 - 15 III 8 - 11 II 4 - 7 I 0 - 3

FORM 1 - GENERAL MATRIX

OFFENDERS NAME:
	ACTIVE CONVICTIONS	CRIME CATEGORY	TIME
MOST SERIOUS		A 1st Degree - Murder B 2nd Degree - Death C 1st Degree - Person D 3rd Degree - Death E 1st Degree - Other F 2nd Degree - Person G 3rd Degree - Person H 2nd Degree - Other I 2nd Degree - Possession J 3rd Degree - Other K 3rd Degree - Possession
NEXT MOST SERIOUS		A 1st Degree - Murder B 2nd Degree - Death C 1st Degree - Person D 3rd Degree - Death E 1st Degree - Other F 2nd Degree - Person G 3rd Degree - Person H 2nd Degree - Other I 2nd Degree - Possession J 3rd Degree - Other K 3rd Degree - Possession
OTHER		A 1st Degree - Murder B 2nd Degree - Death C 1st Degree - Person D 3rd Degree - Death E 1st Degree - Other F 2nd Degree - Person G 3rd Degree - Person H 2nd Degree - Other I 2nd Degree - Possession J 3rd Degree - Other K 3rd Degree - Possession
OTHER		A 1st Degree - Murder B 2nd Degree - Death C 1st Degree - Person D 3rd Degree - Death E 1st Degree - Other F 2nd Degree - Person G 3rd Degree - Person H 2nd Degree - Other I 2nd Degree - Possession J 3rd Degree - Other K 3rd Degree - Possession
TOTAL
SCORER'S NAME:

FORM 3 - SEX OFFENDER MATRIX
CRIMINAL HISTORY ASSESSMENT

TOTAL SCORE: _____________0

CRIMINAL HISTORY ROW III 7 + II 4 - 6 I 0 - 3

FORM 3 - SEX OFFENDER MATRIX

OFFENDERS NAME:
	ACTIVE CONVICTIONS	CRIME CATEGORY	TIME
MOST SERIOUS		A Mandatory Prison 15 to Life B Mandatory Prison 10 to Life C Mandatory Prison 6 to Life D Mandatory Prison 5 to Life E Mandatory Prison 3 to Life F 5 Years to Life G 3 Years to Life H 1 to 15 I 0 to 5 J 0 to 1
NEXT MOST SERIOUS		A Mandatory Prison 15 to Life B Mandatory Prison 10 to Life C Mandatory Prison 6 to Life D Mandatory Prison 5 to Life E Mandatory Prison 3 to Life F 5 Years to Life G 3 Years to Life H 1 to 15 I 0 to 5 J 0 to 1
OTHER		A Mandatory Prison 15 to Life B Mandatory Prison 10 to Life C Mandatory Prison 6 to Life D Mandatory Prison 5 to Life E Mandatory Prison 3 to Life F 5 Years to Life G 3 Years to Life H 1 to 15 I 0 to 5 J 0 to 1
OTHER		A Mandatory Prison 15 to Life B Mandatory Prison 10 to Life C Mandatory Prison 6 to Life D Mandatory Prison 5 to Life E Mandatory Prison 3 to Life F 5 Years to Life G 3 Years to Life H 1 to 15 I 0 to 5 J 0 to 1
TOTAL
SCORER'S NAME:

FORM 2
Aggravating Circumstances

Only use aggravating circumstances if they are not an element of the offense. PSI Page #
  1. Established instances of repetitive criminal conduct.
  2. Multiple documented incidents of violence not resulting in conviction. (Requires court approved
               stipulation.)
  3. Offender presents a serious threat of violent behavior.
  4. Victim was particularly vulnerable.
  5. Injury to person or property loss was unusually extensive.
  6. Offense was characterized by extreme cruelty or depravity.
  7. There were multiple charges or victims.
  8. Offender's attitude is not conducive to supervision in a less restrictive setting.
  9. Offender continued criminal activity subsequent to arrest.
  10. Sex Offenses: Correction's formal assessment procedures classify as a high risk offender.
  11. Offender was in position of authority over victim(s).
  12. Financial crime or theft crime involved numerous victims, an exploitation of a position of trust, a
                 substantial amount of money, or receipt of money from sources including, but not limited to, equity
                 in a person's home or a person's retirement fund.
  13. Offender occupied "position of trust" in relation to murder/homicide victim(s)
                 (U.C.A. 76-3-406.5(2)).
  14. Offense constitutes a "hate crime" in that it is likely to incite community unrest; cause community
                 to reasonably fear for physical safety or freely exercise constitutionally secured rights
                 (U.C.A. 76-3-203.4)
  15. Violence committed in the presence of a child.
  16. Other (Specify)  

FORM 2
Aggravating Circumstances
PSI Page #

FORM 2
Mitigating Circumstances
PSI Page #
  1. Offender's criminal conduct neither caused nor threatened serious harm.
  2. Offender acted under strong provocation.
  3. There were substantial grounds to excuse or justify criminal behavior, though failing to establish
               a defense.
  4. Offender is young.
  5. Offender assisted law enforcement in the resolution of other crimes.
  6. Restitution would be severely compromised by incarceration.
  7. Offender's attitude suggests amenability to supervision.
  8. Offender has exceptionally good employment and/or family relationships.
  9. Imprisonment would entail excessive hardship on offender or dependents.
  10. Offender has extended period of arrest-free street time.
  11. Offender was less active participant in the crime.
  12. All offenses were from a single criminal episode.
  13. Offense(s) was "possession only" drug offense. (see "possession only" offenses, Addendum B)
  14. Offender has completed or has nearly completed payment of restitution.
  15. Other (Specify)  

FORM 2
Mitigating Circumstances
PSI Page #

FORM 2

Days of Jail Credit
Guidelines Recommendation
AP&P Recommendations
Reason For Departure

SCORER'S NAME:
OFFENDERS NAME:

FORM 4
Aggravating Circumstances

The following aggravating circumstances should only be used if they are not an element of the offense.

PSI Page #
  1. The victim suffered substantial bodily injury or serious bodily injury.
  2. The offender has a prior history of such offenses. Prior history could be dependent
               on number of victims, length of involvement, number of incidents, or continued
               involvement subsequent to arrest.
  3. The offense was characterized by extreme cruelty or depravity.
  4. The victim was unusually vulnerable.
  5. There existed a relationship of special trust or offender was in position of authority
               over victim(s).
  6. Offender has previously failed to complete treatment or has completed treatment and
               reoffended.
  7. The suspect was not a member of the victim's immediate family.
  8. The defendant exhibited grooming, stalking or enticing behaviors.
  9. Other (Specify)  

FORM 4
Mitigating Circumstances

PSI Page #
  1. The offense represents a single incident with the offender having no prior history of
               such offenses.
  2. The offender was exceptionally cooperative with law enforcement.
  3. Incest offender has strong, supportive family relationships.
  4. Offender is a good candidate for a recognized treatment program. Substance abuse
               treatment may be appropriate if the offense was specifically substance related.
  5. Developmental disabilities of the offender may be considered in mitigation if highly
               structured alternatives can be utilized to control the offender's criminal behavior.
  6. Other (Specify)  

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OFFENDERS NAME:
SCORER'S NAME:

FORM 4

OFFENDERS NAME:
SCORER'S NAME:

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