PM [2004] No. 3 Attachment No. 3 EN Ministry of the Attorney General Ministère du Procureur général VICTIM IMPACT STATEMENT Date…SEPT 9/09……………….…… Victim’s Name LOPES RICARDO …………………………………………………………………………… Family Name First Name If you are not the direct victim of the crime please describe your relationship to the case: ………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………… Accused’s Name (if known) LOSER………………………………………………………………………. Family Name D.O.B.………….…………………………………… Investigating Officer ………………………………………………………………………. (Family Name, Rank, Badge Number) Tel./N° Would you like to read this statement to the judge? YES NO x PLEASE RETURN THIS COMPLETED FORM TO THE POLICE After you have returned your completed Victim Impact Statement to the investigating officer, a copy will be made for the accused and his/her lawyer and you may be cross-examined on the contents. PM [2004] No. 3 Attachment No. 3 EN It is important that you keep in touch with the police respecting upcoming court dates since the offender may plead guilty at any time and your Statement must be filed with the court as soon as possible after a finding of guilt. Please remember that the Victim Impact Statement is about you, not the accused. Please focus on providing a description of the impact of the crime on your life. Quite understandably, emotions run high in these situations but it is important not to include vengeful comments, criticisms or rumours about the accused. Such comments will not assist the judge and may detract from your statement. Please indicate any probation conditions that would be helpful for you, in your Victim Impact Statement, including if you do or do not want contact with the accused. Please indicate any concerns about your personal safety. Please do not include suggestions about the sentence. Please try not to describe the crime in your Victim Impact Statement. The judge has already found the accused guilty based on what has been found to have occurred. Therefore, it is not helpful, at this point, to offer more information about the circumstances of the offence. 1. EMOTIONAL LOSS Please describe how this offence has affected you? (Please attach extra sheets, if needed) …………………………………………………………………………………………………………………………………… I cannot sleep, I cannot eat, I have nightmares and night sweats. It is difficult for me to reach the door of my apartment, to cross the doorway and to step into the hallway…to think that I have to step out in the open, outside the safety of the doors of my building. I don’t know why this man chose to attack me…I am not a terrorist and I am not a PAKI! I cannot do anything about the color of my skin or the way I look. I was born and raised here by hardworking parents who showed me right from wrong. I worked hard all my life so my parents would be proud of me and I wanted to prove myself to everyone around me…I wanted to prove that I was a good Canadian. Now I wonder what I am doing here in Toronto. How can I be safe? How can my family be safe? If I step out to get a pizza because I am celebrating the end of an exam, and then I get attacked because of who I am…how can I live here? But I have no where to go…where can I go? This is my home. I feel tired, my partner Maria gets emotional and feels guilty and then I feel more ashamed. My parents are in a state of shock and they even asked me: what did I do to deserve this attack? I have no answer for them…I know I did nothing but I have no answer for my parents’ fear and worry about me. I want to know that this will never happen to me or to someone who looks like me…but every time I look at people like him, I get more scared and I want to stay indoors and don’t want anyone from my family to go out as well. I don’t want them to get attacked too. …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… PM [2004] No. 3 Attachment No. 3 EN 2. PHYSICAL INJURY Please list the injuries and the treatment you received, including any permanent (Please attach extra sheets, if needed.) Disabilities. …………………………………………………………………………………………………………………………………… …… On a physical level, the pain of dealing with broken bones can be managed by medication, but the gnawing fear I have that the break will affect my capacity and capability to perform surgery in the field of neurosurgery that I am training for…this fear cannot be shaken away by these pain killers. …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… PM [2004] No. 3 Attachment No. 3 EN 3. FINANCIAL IMPACT – Please list any financial loss you may have suffered as a result of this incident. For example, medical expenses not covered by insurance, lost wages, any property that was damaged, destroyed or lost and the value of that property. Please attach copies of all bills, receipts or estimates you may have. (Please attach extra sheets, if needed.) Please note that providing information about the financial impact of a crime may not necessarily lead to payment for your losses or expenses through the criminal justice system. …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………… ………………I I have not been able to work and have had to remain home while my injuries heal. I estimate I have lost thousands of dollars in salary. My prospect of being a neurosurgeon are now compromised by this horrific offense. The financial impact of this offense will be ongoing for me.… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………… The statements I have made are true to the best of my knowledge. ………………………………………………………………. Date ………………………………………………… 19.……… (Signature of Victim or of Person Completing this Form) Did you complete this statement on behalf of the victim? If you have completed this statement on behalf of the victim, please indicate why, and what your relationship is to the victim. (PLEASE PRINT) ………………………………………………………………………………………………………………………………… … Family Name First Name Relationship REASON:……………………………………………………………………………………………………………. Did you provide translation or interpretation assistance to the victim to complete this statement? If you have assisted the victim by providing interpretation services to enable the victim to complete this form please indicate your name and your relationship (if any) to the victim. Please attach any original victim impact statements written by the victim in her/his own language with this document. …………………………………………. ……………………………………………. Name of Interpreter Relationship to the victim