STATE OF SOUTH CAROLINA ) IN THE COURT OF GENERAL SESSIONS

)
COUNTY OF ____________________________________ )
)
STATE ) INDICTMENT/CASE#: -GS- -
VS. )
)
) A/W#:
AKA: ) Date of Offense:
Race: Sex: Age: ) S.C. Code §:
DOB: SS#: ) CDR Code #:
Address: )
City, State, Zip: ) SENTENCE SHEET
DL#* SID# )
)
*CDL Yes No CMV Yes No Hazmat Yes No

In disposition of the above indictment comes now the Defendant who was CONVICTED OF or PLEADS

TO:

In violation of § of the S.C. Code of Laws, bearing CDR Code #

NON-VIOLENT VIOLENT SERIOUS MOST SERIOUS Mandatory GPS § 17-25-45

(CSC w/minor 1st or CSC w/minor 3rd)
Lesser Included Defendant Waives
The charge is: As indicted,
Offense, Presentment to Grand Jury. (def.’s initials)

The plea is: Without Negotiations or Recommendation, Negotiated Sentence, Recommendation by the State.
ATTEST:

Solicitor SC Bar # Defendant Attorney for Defendant SC Bar #

WHEREFORE, the Defendant is committed to the State Department of Correction County Detention Center,

for a determinate term of days/months/years/Time Served Youthful Offender Act not to exceed years

and/or to pay a fine of $ ; provided that upon the service of days/months/years/Time Served and or payment

of $ ; plus costs and assessments as applicable*; the balance is suspended with probation for _______________

months/years and subject to South Carolina Department of Probation, Parole and Pardon Services standard conditions of
probation, which are incorporated by reference.

The sentence shall run

CONCURRENT or CONSECUTIVE to sentence on:

The Defendant is to be given credit for time served pursuant to S.C. Code § 24-13-40 to be calculated and applied by SCDOC.
days/months
To include time spent on monitored house arrest prior to trial and sentencing.
The Defendant Shall be Released from County Detention Center.

Pursuant to 18 U.S.C. § 922 and § 16-25-30 it is unlawful for a person convicted of a violation of § 16-25-20 or § 16-25-65
(Domestic Violence) to ship, transport, possess, or receive a firearm or ammunition.
 STATE VS. INDICTMENT/CASE#: -GS- -

SPECIAL CONDITIONS:

PTUP after months/years

And Other Terms Listed Below:

Substance Abuse Counseling Completion of GED Random Drug/Alcohol Testing

Attend Voc. Rehab. Or Job Corp No Contact with Victim Domestic Violence Intervention Program

Mental Health Counseling May serve W/E

beginning:

Sex Offender Registry pursuant to S.C. Code § 23-3-430 Public Service Employment days/hours

Central Registry of Child Abuse and Neglect pursuant to S.C. Code § 17-25-135.

Other:

RESTITUTION: Deferred Def. Waives Hearing Ordered

Total $_______ plus 20% fee: $________

Payment Terms: Set by SCDPPPS

Recipient:

*Fine: $
Fine may be pd. in equal consecutive weekly/monthly pmts. of $ Beginning
§14-1-206 (Assessments 107.5%) $
§14-1-211 (A)(1)(Conv. Surcharge) $100 $
§14-1-211 (A)(2)(DUI Surcharge) $100 $
§56-5-2995 (DUI Assessment) $12 $
§56-1-286 (DUI Breath Test) $25 $
§14-1-212 (Law Enforce. Funding) $25 $
§14-1-213 (Drug Court Surcharge) $150 $
§34-11-70(b)and(c), and 34-11-90(c)and(d) (Admin Fraud Check Court Costs) $41 $
§50-21-114 (BUI Breath Test Fee) $50 $
§56-5-2942(J) (Vehicle Assessment) $40/ea $
3% to County (if paid in installments) TBD $
Appointed PD or appointed other counsel, Proviso requires $500 be paid to Clerk
during probation and shall be collected before any other fees $500 $
§ 17-3-30(B) Unpaid Application Fee to be paid to the Public Defender Fund TBD $
TOTAL $

Presiding Judge:
Clerk of Court/Deputy Clerk: Judge Code:
Court Reporter: Sentence Date:

SCCA/217 (07/2021) Page 2 of 2