Presentation of the community impact statement to the court for the purpose of sentencing; Contact information of designated person; and notice of change of address (SJ-1121A)
If you are unable to download or print this document, please contact us. We will show you another way to obtain this information.
Certain pleadings and accompanying documents (forms, proof of notification, etc.) can be sent to court offices electronically. Learn more.
 | This form may be used by the individual designated by a community to:
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For more information on the Community Impact Statement.
Version: February 2023
Type of File:Dynamic PDF
Minimum required version of Adobe Reader: 7
More information
Only forms with a duly completed File identification section will be processed.
Contact the police force (in French) responsible for investigating the offence for more details concerning the information required in the File identification section.
Contact the Ministère or a victim of crime assistance centre (CAVAC) if you have any other questions concerning the form.
Send the form to the clerk’s office at the Court of Québec, Criminal and Penal Division, in the judicial district where judicial proceedings were instituted against the accused.
A printed version of the form may be obtained from a victim of crime assistance centre (CAVAC).
