Psi Report Long Form

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Presentence Investigation Form Fill out completely and accurately. If you are unsure of an answer, estimate to the best of your knowledge and note that it is an estimate. All information will be verified and any discrepancies will be noted to the Court. Defendant Information Full (Legal) Name: ____________________________________________________________ _____ Alias or Nickname: ______________________ __________________________________________ Current Address: _____________________________________Phone:_______________________ City______________________________________State________Zip__ ______________________ Permanent Address: ____________________________________________________________ ___ (if different from above) Date of…show more content…
Maiden Name)____________________________________ Address______________________________________Phone__________ _________ Any Criminal History?_________________________________________________ Substance Abuse Problems or Mental Illness? ________________________________ Is she employed?____Was your mother married to your biological (natural) father?____ If yes, are they still married?_______________________________________________ If they divorced, how old were you and why did they divorce? ____________________ ____________________________________________________________ _________ How did it affect you?____________________________________________________ Who primarily raised you?________________________________________________ Did you spend time with your non-custodial parent?____________________________ ____________________________________________________________ _________ Did your mother have any other marriages?___________________________________ To whom?____________________________________________________________ _ Do or did you get along with your mother’s husband/significant other?______________ What is your relationship with your mother like?________________________________ ____________________________________________________________ _________ Is your Father still living?_______________________If not, date deceased__________ Father’s Legal
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