Ontario Review Board

New Accused Information Sheet

151 Bloor Street West, 10th Floor
Toronto ON M5S 2T5
Telephone: (416) 327-8866
Fax: (416) 327-8867

Instructions for completion and distribution are on reverse side of form.

Section A - Identification Data

Name of accused
Last name

First name

Initial

Sex
F M

Young person
Yes No

AKA
NA

AKA

Birth date
(dd/mm/yy)

Criminal charges (use Criminal Code of Canada section numbers upon which verdict found)
1.
2.
3.
4.
5.
6.
7.
8.

Section B - Court Data

Court verdict
Unfit to stand trial Not Criminally Responsible (NCR)

Court verdict date (dd/mm/yy)

Name of court judge
Last name

First name

Name of court house
Name of court house

Court division
General Provincial

Name of officer in charge (complete only if unfit)
Last name

First name

Police force municipality

Badge no.

Name of crown or assistant crown
Last name

First name

Fax no.

Address (provide City of home office only)

Telephone no.

Name of defence counsel
Last name

First name

Address

City

Province

Postal code

Fax no.

Telephone no.

Court decision
Remanded for Review Board hearing pursuant to S.672.47(1)
OR
Court disposition made pursuant to S.672.47(3)

Location of accused (check appropriate situation)
Detained in hospital/jail facility
(indicate name of hospital/jail)

Residing in community (provide address and telephone no.)
Address

City

Province

Postal code

Telephone no.

Interpreter needed
No
Yes (specify language/sign)

Section C - Court Documentation Checklist Data

1. True copies of endorsed information/indictment

Unfit

Required: Yes

Attached

Not Criminally Responsible

Required: Yes

Attached

2. Synopsis of offence(s) or agreed statement of facts

Unfit

Required: Yes

Attached

Not Criminally Responsible

Required: Yes

Attached

3. Criminal record of accused

Unfit

Required: Yes

Attached

Not Criminally Responsible

Required: Yes

Attached

4. Psychiatric report(s)

Unfit

Required: Yes

Attached

Not Criminally Responsible

Required: Yes

Attached

5. Transcript of court disposition made pursuant to S.672.47(3)

Unfit

Required: Yes

Attached

Not Criminally Responsible

Required: Yes

Attached

6. Warrant of committal (Form 49)/Interim release order

Unfit

Attached

Not Criminally Responsible

Attached

7. Other
(specify)

Unfit

Attached

Not Criminally Responsible

Attached

Signature

Name of person completing form (print)

Telephone no.

Signature of person completing form

Date (dd/mm/yyyy)

3143-04 (05/12)

Name of Accused
Last name

First name

Initial

Section D - Victim
Name of victim

Last name

First name

Address

City

Province

Postal code

Telephone no.

Name of victim

Last name

First name

Address

City

Province

Postal code

Telephone no.

Section E - Additional Identification Data (Young Person)
Name of father
Last name

First name

Address

City

Province

Postal code

Telephone no.

Name of mother
Last name

First name

Address

City

Province

Postal code

Telephone no.

Section F - Additional Comments

Additional Comments

Collection of personal information contained on this form is authorized under Part XX.1 of the Criminal Code, for the purpose of notifying the Review Board of those persons that are unfit to stand trial or not criminally responsible and victims. For information about collection practices, contact the Deputy Registrar, Ontario Review Board, 151 Bloor Street West, 10th Floor, Toronto ON M5S 2T5, telephone (416) 327-8866, fax (416) 327-8867.

Instructions for Completion and Distribution

Completion of this form:

- Please print (i.e. do not write) all required information.
- Provide all first names in full (i.e. do not use initials).
- If the accused is an adult, then complete Sections A, B, C and D.
- If the accused is a young person, then complete Sections A, B, C, D and E.
- If you wish to provide additional information, then complete Section F.

Distribution of this form and court documentation to the Review Board within two (2) working days after the court verdict or disposition as follows:

- Send this form (both sides) by facsimile to fax number (416) 327-8867.
- Send the required court documentation either by facsimile or by mail to:

Ontario Review Board
151 Bloor Street West, 10th Floor
Toronto ON M5S 2T5
Telephone: (416) 327-8866

Distribution of this form (without court documentation) as follows:

- To Regional Director of Crown Attorneys for region where verdict was rendered.
- To Regional Director of Crown Attorneys where the accused is located, i.e., place of detention.

3143-04 (05/12)