Fill and Sign the Defendant Criminal Form

Defendant’s Name: ____________________________________________ Case No .:_________________________ Certificate of Defendant’s Criminal History (CERTDCH) The undersigned prosecuting attorney states that, to the best of his or her knowledge, the following information, together with the Abstract of Driving Record, complies with the requirements of RCW 46.61.513. The following convictions (including deferred prosecutions) appear within the judicial information system or are otherwise available to the court or the prosecutor, and are current within the period set forth in RCW 46.61.513(3): 1. DUI or Physical Control convictions (including deferred prosecutions) for which the defendant was arrested within seven years before or after the date of arrest for the current offense: (Crime:__________________________________________ Date:__________________________) 2. Negligent Driving 1  , Reckless Driving, Reckless Endangerment convictions originally filed as a DUI or Physical Control or Vehicular Homicide or Assault for which the defendant was arrested within seven years before or after the date of arrest for the current offense: (Crime:___________________________________________ Date:_________________________) 3. Vehicular Homicide or Assault convictions, committed while under the influence of intoxicating liquor or any drug, for which the defendant was arrested within seven years before or after the date of arrest for the current offense: (Crime:___________________________________________ Date:_________________________) 4. Vehicular Homicide or Assault convictions committed in a reckless manner or with the disregard for the safety of others originally filed as Vehicular Homicide or Assault convictions, committed while under the influence of intoxicating liquor or any drug for which the defendant was arrested within seven years before or after the date of arrest for the current offense: (Crime:___________________________________________ Date:_________________________)  Total number of convictions from 1, 2, 3 and 4 ( determines mandatory minimum ): (_________). 5. DUI or Physical Control and Vehicular Homicide or Assault convictions (including deferred prosecutions) for which the defendant was arrested more than seven years before or after the date of arrest for the current offense: (Crime:___________________________________________ Date:_________________________)  Total number of convictions (including deferred prosecutions) from 1, 2, 3, 4 and 5: (_________).  Negligent Driving 1  , Reckless Driving, Reckless Endangerment convictions: (Crime:___________________________________________ Date:__________________________)  DWLS 1  / DWLS 2  convictions: (Crime:___________________________________________ Date:__________________________)  DWLS 3  convictions: (Date: )  Other relevant criminal convictions: .  Injury or damage to another: Yes No; another’s property: Yes No Unknown  Passengers in car during current offense: Yes No Unknown Number of passengers (_________), Number of those passengers under age 16 (__________). Dated:_____________________________ Prosecuting Attorney WSBA No. Updated:_______________________ (Date), _______________ (Prosecutor’s Initials and WSBA No.) RCW 46.61.513 (1) Immediately before the court defers prosecution under RCW 10.05.020, dismisses a charge, or orders a sentence for any offense listed in subsection (2) of this section, the court and prosecutor shall verify the defendant's criminal history and driving record. The order shall include specific findings as to the criminal history and driving record. For purposes of this section, the criminal history shall include all previous convictions and orders of deferred prosecution as reported through the Certificate of Defendant’s Criminal History (CERTDCH) - Page 1 of 2 CrRLJ 07.0400 - (09/2011) RCW 46.61.513 judicial information system, or otherwise available to the court or prosecutor, current to within the period specified in subsection (3) of this section before the date of the order. For purposes of this section, the driving record shall include all information reported to the court by the Department of Licensing. (2) The offenses to which this section applies are violations of: (a) RCW 46.61.502 or an equivalent local ordinance; (b) RCW 46.61.504 or an equivalent local ordinance; (c) RCW 46.61.520 committed while under the influence of intoxicating liquor or any drug; (d) RCW 46.61.522 committed while under the influence of intoxicating liquor or any drug; and (e) RCW 46.61.5249, 46.61.500, or 9A.36.050, or an equivalent local ordinance, if the conviction is the result of a charge that was originally filed as a violation of RCW 46.61.502 or 46.61.504 or an equivalent local ordinance, or of RCW 46.61.520 or 46.61.522. (3) The periods applicable to previous convictions and orders of deferred prosecution are: (a) one working day, in the case of previous actions of courts that fully participate in the state judicial information system; and (b) seven calendar days, in the case of previous actions of courts that do not fully participate in the judicial information system. For purposes of this subsection, "fully participate" means regularly providing records to and receiving records from the system by electronic means on a daily basis. Certificate of Defendant’s Criminal History (CERTDCH) - Page 2 of 2 CrRLJ 07.0400 - (09/2011) RCW 46.61.513