Homicide Survey - Charged/Suspect-Chargeable Questionnaire: 2005 to 2014

Canadian Centre for Justice Statistics
Exempt from Access Under any Legislation

Please provide information as the time of the incident for each chargeable suspect.

See instructions below for items indicated with an asterix (*) or refer to the scoring guide for the homicide survey available on the CCJS Extranet Website.

  1. Incident file number:
  2. Chargeable suspect number:
  3. Name of chargeable suspect:
    • Surname,
    • Given name(s)
    • Alias
    • Unknown
  4. Gender of chargeable suspect:
    • Male
    • Female
  5. Date of birth of chargeable suspect
    • Year/Month/ Day

    If chargeable suspect's date of birth is unknown, estimate the age at time of incident

    • Years
    • Unknown
  6. Marital status of chargeable suspect
    • Single (never married)
    • Married (legal)
    • Common-law / cohabitation
    • Divorced
    • Separated (legal or informal)
    • Widowed
    • Unknown
  7. Aboriginal origin of chargeable suspect
    • Not collected / released by police force
    • Non-aboriginal origin
    • North American Indian
    • Métis
    • Inuit
    • Not provided by the chargeable suspect
    • Unknown
  8. Employment status of chargeable suspect (check one only; if more than one applies, check the response closest to the top of the list)
    • Illegal activities (e.g. prostitute, drug dealer, gang member)
    • Employed (includes full-time, part-time, casual, self-employed)
    • Unemployed
    • Unknown

    Not in labour force (Go to Question 10)

    • Less than 15 years of age (Go to Question 10)
    • Student (Go to Question 10)
    • Retired (Go to Question 10)
    • Homemaker (Go to Question 10)
    • Other - specify (e.g. social assistance, disability) (Go to Question 10)
  9. Occupation of chargeable suspect (enter most recent occupation or other occupation directly related to the homicide)
    • Specify ; or
    • Unknown
  10. Country of residence of chargeable suspect
    • Canada
    • United States
    • Other country
    • Unknown
  11. Clearance status of chargeable suspect
    • Charges laid or recommended
    • Cleared by suicide of chargeable suspect (Go to Question 13)
    • Cleared otherwise - specify (Go to Question 13)
  12. Most serious charge laid or recommended against the chargeable suspect
    • Murder 1st-degree
    • Murder 2nd-degree
    • Manslaughter
    • Infanticide
  13. Finger Print System (FPS) number of chargeable suspect
    • Specify
    • No applicable
    • Unknown
  14. Chargeable suspect's previous conviction for criminal activities
    • No previous conviction
    • Unknown

    Specify source of information (e.g., CPIC, your own information system, etc.)

    Most serious conviction

    • Homicide
    • Robbery
    • Other violent offence
    • Property offence
    • Drug offence
    • Other Criminal Code or Federal/Provincial Statute offence
  15. Suspected mental or developmental disorder (e.g., schizophrenia)
    • Suspected
    • Yes – specify
    • No
    • Unknown
  16. Consumption of alcohol, drug or intoxicating substance by chargeable suspect (check one only)
    • No alcohol or drug consumed
    • Both alcohol and drug consumption
    • Alcohol consumption only
    • Drug consumption only
    • Consumption of intoxicating substance- inhalant, etc.
    • Consumption of intoxicant – type unknown
    • Unknown
  17. History of family violence involving this chargeable suspect and any homicide victim(s) in this incident*
    • Not a family homicide
    • Yes
    • No
    • Unknown


The investigating officer is the ideal person to complete this form

*History of family violence - refers to violence (e.g. spousal abuse, child or parent battering) between family members (codes 1 to 23 on question 24 of the Victim Questionnaire). Even one previously known incidence of violence is sufficient to score "Yes". The violence must involve this accused person and the victim killed in this incident.

Thank you for your co-operation

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