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Annex B Specific Community Impact Statement Template

Community Impact Statement

A statement made under S9 of the Criminal Justice Act 1967 and tendered under Part 27 of the Criminal Procedure Rules 2010.

Area(s) affected:

Community group(s) affected:

Statement Author:

Community Statement:

The following information describes the areas of concern and the impact of the incident as noted by the community:-



  • Westminster Neighbourhood Watch 15 people present 
  • Neighbourhood Police community meeting 13 people present

Guidance for this section:

1) Statement explain the nature of the offence and the circumstances under which it was committed.

2) Impact on the community it is useful to explain how the specific offence has affected the community; this can be shown through quotes or background information and should emphasise the harm caused by the offence.

Statement example:

1) I have made this community impact statement to provide local context surrounding the offending on XXXX2010 at approximately 22.50 where a playground was set on fire on XXXXX Road, XXXX, Kent. The statement also describes the impact and harm caused by the offence on the community.

2) This specific offence has had a significant impact on the local community. One resident said We helped design the playground and now feel our contribution has been destroyed. The playground was on our doorstep and now my children have nowhere local to play. The next nearest playground is miles away in an area that Im too scared to take my children to because it is known for muggers .

The following data lists the number of recorded cases of (insert name of offence(s) type committed by named offender) in the area for the noted period. The same data has been recorded nationally for the same period for comparison purposes.

(Statistics on prevalence do not need to be included if the information under concerns of the community robustly illustrates the extent of harm caused to the community)

Name of area:
Local National:
For example June 10 July 10 Aug 10 June 10 July 10 Aug 10
i.e Arson

This statement (consisting of ___  pages) is true to the best of my knowledge and belief and I make it knowing that if it is tendered in evidence, I shall be liable to prosecution if I have wilfully stated on it anything which I know to be false or do not believe to be true.