Victim Impact Statement Form - Texas
This Victim Impact Statement (VIS) will be used throughout
the criminal justice system (by the prosecutor, the judge, and
the parole board) to better understand the emotional/
psychological, physical, and financial impact of the crime.
The contact information you provide in this Victim Impact
Statement is important and will be used to contact you if you
wish to receive information from:
Community Supervision and Corrections Department
(probation);
Texas Department of Criminal Justice (prison); and
Board of Pardons and Paroles.
Return the
Confidential Victim Contact Information and the
Victim Impact Statement to the
county or district attorney’s office
that is prosecuting your case.
TO BE COMPLETED BY THE VICTIM ASSISTANCE COORDINATOR
Victim Assistance Coordinator:
Agency:
Address:
City: Zip Code:
Phone: Fax:
E‐mail:
REMOVE AND KEEP FOR YOUR RECORDS
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