Fill and Sign the Note the Trial Judge Shall Ensure the Form

OCCA Online Rules of the Court of Criminal Appeals Form 13.10 Uniform Plea of Guilty - Summary of Facts IN THE DISTRICT COURT OF _____ COUNTY THE STATE OF OKLAHOMA STATE OF OKLAHOMA, Plaintiff, vs. _____________________________________, ) )))))))) Case No. _____________________ [NOTE: The trial judge shall ensure the defendant is sworn either prior to completing the Summary of Facts or prior to inquiry by the Court on the Plea. If the defendant is entering a nolo contendere, or other type guilty plea, correct by pen change where term "guilty" PLEA OF GUILTY SUMMARY OF FACTS Part A: Findings of Fact, Acceptance of Plea CIRCLE 1. Is the name just read to you your true name? Yes No If no, what is your correct name? _________________ __________________________________________________ I have also been known by the name(s):___________ _________________________________________________. 2. (a) Do you wish to have a record made of these proceedings by a Court Reporter? Yes No (b) Do you wish to waive this right? Yes No 3. Age:______ Grade completed in school:____________ 4. Can you read and understand this form? (If the answer above is no, Addendum A is to be completed and attached.) Yes No 5. Are you currently taking any medications or substances which affect your ability to understand these proceedings? Yes No 6. Have you been prescribed any medication that you should be taking, but you are not taking? Yes No If so, what kind and for what purpose?____________ __________________________________________________ 7. Have you ever been treated by a doctor or health professional for mental illness or confined in a hospital for mental illness? Yes No If yes, list the doctor or health professional, place, and when occurred: ________________________________________________________________________________ 8. Do you understand the nature and consequences of this proceeding? Yes No 9. Have you received a copy of the Information and read its allegations? Yes No 10. A. Do you understand you are charged with: Yes No Crime Statutory Reference (1) _________________________ _______O.S._________ Yes No (2) _________________________ _______O.S._________ Yes No (3) _________________________ _______O.S._________ Yes No (4) _________________________ _______O.S._________ Yes No For additional charges: List any additional charges on a separate sheet and label as PLEA OF GUILTY ADDENDUM B. B. Are you charged after former conviction of a felony? Yes No If yes, list the felony(ies) charged:__________________ __________________________________________________________________________________________ 11. Do you understand the range of punishment for the crime(s) is/are: (List in same order as in No. 9 above.) (1) Minimum of ________ to a maximum of ________ and/or a fine of $_______ Yes No (2) Minimum of ________ to a maximum of ________ and/or a fine of $_______ Yes No (3) Minimum of ________ to a maximum of ________ and/or a fine of $_______ Yes No (4) Minimum of ________ to a maximum of ________ and/or a fine of $_______ Yes No For additional charges: List any additional punishments on a separate sheet, with additional crimes and labeled as PLEA OF GUILTY ADDENDUM B. 12. Read the following statements: You have the right to a speedy trial before a jury for the determination of whether you are guilty or not guilty and if you request, to determine sentence. (If pleading to capital murder, advise of procedure in 21 O.S. ฀ 701.10(B)). At the trial: (1) You have the right to have a lawyer represent you, either one you hire yourself or if you are indigent a court appointed attorney. (2) You are presumed to be innocent of the charges. (3) You may remain silent or, if you choose, you may testify on your own behalf. (4) You have the right to see and hear all witnesses called to testify against you and the right to cross-examine them. (5) You may have your witnesses ordered to appear in court to testify and present evidence of any defense you have to these charges. (6) The state is required to prove your guilt beyond a reasonable doubt. (7) The verdict of guilty or not guilty decided by a jury must be unanimous. However, you can waive a jury trial and, if all parties agree, the case could be tried by a Judge alone who would decide if you were guilty or not guilty and if guilty, the appropriate punishment. Do you understand each of these rights? Yes No 13. Do you understand by entering a plea of guilty you give up these rights? Yes No 14. Do you understand that a conviction on a plea of guilty could increase punishment in any future case committed after this plea? Yes No 15. Is ________________________________ your lawyer? Yes No 16. Have you talked over the charge(s) with your lawyer, advised him/her regarding any defense you may have to the charges and had his/her advice? Yes No 17. Do you believe your lawyer has effectively assisted you in this case and are you satisfied with his/her advice? Yes No 18. Do you wish to change your plea of not guilty to guilty and give up your right to a jury trial and all other previously explained constitutional rights? Yes No 19. Is there a plea agreement? Yes No What is your understanding of the plea agreement?____ _____________________________________________ _____________________________________________ 20. Do you understand the Court is not bound by any agreement or recommendation and if the Court does not accept the plea agreement, you have the right to withdraw your plea of guilty? Yes No 21. Do you understand that if there is no plea agreement the Court can sentence you within the range of punishment stated in question 11? Yes No 22. Do you understand your plea of guilty to the charge(s) is after: (check one) Yes No ( ) no prior felony convictions ( ) one (1) prior felony conviction ( ) two (2) or more prior felony convictions List prior felony convictions to which pleading:_____________________________________________________ 23. What (is) (are) your plea(s) to the charge(s) (and to each one of them)? ______ 24. Did you commit the acts as charged in the Information? Yes No State the factual basis for your plea(s) (attach additional page as needed, labeled as ADDENDUM C): __________________________________________________________________________________________________ 25. Have you been forced, abused, mistreated, or promised anything by anyone to have you enter your plea(s)? Yes No 26. Do you plead guilty of your own free will and without any coercion or compulsion of any kind? Yes No 27. If you are entering a plea to a felony offense, you have a right to a Pre-Sentence Investigation and Report which would contain the circumstances of the offense, any criminal record, social history and other background information about you. Do you want to have the Report? Yes No 28. (a) Do you have any additional statements to make to the Court? Yes No (b) Is there any legal reason you should not be sentenced now? Yes No HAVING BEEN SWORN, I, the Defendant whose signature appears below, make the following statements under oath: (1) CHECK ONE: ______(a) I have read, understood and completed this form. ______(b) My attorney completed this form and we have gone over the form and I understand its contents and agree with the answers. See Addendum "A". ______(c) The Court completed this form for me and inserted my answers to the questions. (2) The answers are true and correct. (3) I understand that I may be prosecuted for perjury if I have made false statements to this Court. ___________________________________________ DEFENDANT Acknowledged this ______ day of _______________, 20____. ________________________________________________ Notary Public/Deputy Court Clerk/Judge 29. I, the undersigned attorney for the Defendant, believe the Defendant understands the nature, purpose and consequence of this proceeding. (S)He is able to assist me in formulating any defense to the charge(s). I am satisfied that the Defendant's waivers and plea(s) of guilty are voluntarily given and he/she has been informed of all legal and constitutional rights. ___________________________________________ ATTORNEY FOR DEFENDANT 30. The sentence recommendation in question 19 is correctly stated. I believe the recommendation is fair to the State of Oklahoma. 31. Offer of Proof (Nolo contendere plea)____________________________ _______________________________________________________________ ___________________________________________ ASSISTANT DISTRICT ATTORNEY THE COURT FINDS AS FOLLOWS: 32. A. The Defendant was sworn and responded to questions under oath. B. The Defendant understands the nature, purpose and consequences of this proceeding. C. The Defendant's plea(s) of _________________ is/are knowingly and voluntarily entered and accepted by the Court. D. The Defendant is competent for the purpose of this hearing. E. A factual basis exists for the plea(s) (and former conviction(s), if applicable). F. The Defendant is guilty as charged: (check as appropriate) ( ) after no prior felony convictions. ( ) after one (1) prior felony conviction. ( ) after two (2) or more prior felony convictions. G. Sentencing or order deferring sentence shall be: imposed instanter ( ); or continued until the _____ day of _______________, 20___, at __________ ___.m. If the Pre-Sentence Investigation and Report is requested, it shall be provided to the Court by the _____ day of _____________, 20___. DONE IN OPEN COURT this ______ day of _______________, 20____. ____________________________ __________________________________________ Court Reporter Present JUDGE OF THE DISTRICT COURT ____________________________ _____________________________________________ Deputy Court Clerk NAME OF JUDGE TYPED OR PRINTED Part B: Sentence on Plea Case No._________________ State v. ________________ Date: ___________________ [NOTE ON USE: Part B to be used with the Summary of Facts if contemporaneous with the entry of plea or may be formatted as a separate sentencing form if sentencing continued to future date.] THE COURT SENTENCES THE DEFENDANT AS FOLLOWS:TIME TO SERVE 1. You are sentenced to confinement under the supervision of the Department of Corrections for a term of years as follows: (list in same order as in question No. 10 in Part A) ___________________________________________________ ___________________________ ___________________________________________________ ___________________________ ___________________________________________________ ___________________________ ___________________________________________________ ___________________________ 2. The sentence(s) to run (concurrently/consecutively) _________________________ _____________________________________________ or NOT APPLICABLE ___________DEFERRED SENTENCE 1. The sentencing date is deferred until ____________ __ __, 20___ at ___________ ___.m. 2. You (will/will not) be supervised. The terms set forth in t he Rules and Conditions of Probation found in Addendum D shall be the rules you must follow during the period of deferment. SUSPENDED SENTENCE or SUSPENDED AS TO PART 1. You are sentenced to confinement under the supervision of the Department of Corrections for a term of years as follows: ___________________________________________________ ___________________________ ___________________________________________________ ___________________________ ___________________________________________________ ___________________________ to be suspended as follows: (a) ALL SUSPENDED YES_____ NO_____ (b) suspended except as to the first ________ (months)(years) of the term(s) during which time you are to be held in the custody of the Department of Corrections, the remainder of the sentence(s) to be suspended under the terms set forth in the Rules and Conditions of Probation found in Addendum D. 2. The sentence(s) to run (concurrently/consecutively) _______________________ ________________________________________________________ or NOT APPLICABLE. FINES AND COSTS You are to pay a fine(s), costs, fees and/or restitution to the ________________ County District Court Clerk as set out in Addendum E which is attached and made a part of this Order. [NOTE ON USE: District Courts may develop and utilize schedules for payment of fines and costs as appropriate for each d istrict and attach as Addendum E.] "NOTICE OF RIGHT TO APPEAL" Sentence to Incarceration, Suspended or Deferred: To appeal from this conviction, or order deferring sentence, on your plea of guilty, you must file in the District Court Clerk's Office a written Application to Withdraw your Plea of Gui lty within ten (10) days from today's date. You must set forth i n detail why you are requesting to withdraw your plea. The trial court must hold a hearing and rule upon your Application within thirty (30) days from the date it is filed. If the trial court denie s your Application, you have the right to ask the Court of Cri minal Appeals to review the District Court's denial by filing a P etition for Writ of Certiorari within ninety (90) days from the date of the denial. Within ten (10) days from the date the applica tion to withdraw plea of guilty is denied, notice of intent to appeal and designation of record must be filed pursuant to Oklahoma Court of Criminal Appeals Rule 4.2(D). If you are indigent, you have the right to be represented on appeal by a court appoi nted attorney. Do you understand each of these rights to appeal? Yes No Do you want to remain in the county jail ten (10) days before being taken to the place of confinement? Yes No Have you fully understood the questions that have been asked? Yes No Have your answers been freely and voluntarily given? Yes No I ACKNOWLEDGE UNDERSTANDING OF RIGHTS AND SENTENCE IMPOSED. ______________________________________ Defendant I, the undersigned attorney, have advised the Defendant of his appellate rights. ______________________________________ Attorney for Defendant Done in open court, with all parties present, this ______ day of __________________ 20____. _______________________________ ______________________________________________ Court Reporter Present Judge of the District Court ____________________________________ Deputy Court Clerk ADDENDUM "A" CERTIFICATE OF DEFENSE COUNSEL As the attorney for the defendant,_____________________ ________________, I certify that: 1. The Defendant has stated to me that he/she is (able/un able) to read and understand the attached form, and I have: (check appropriate option) ___________ determined the Defendant is able to understa nd the English language. ___________ determined the Defendant is unable to unde rstand the English language and obtained _______________________________________ to interpret. 2. I have read and fully explained to the Defendant the allegations contained in the Information in this case. 3. I have read and fully explained to the Defendant all of the questions in the Plea of Guilty/Summary of Facts and the answers to the questions set out in the Summary of Facts are the Defendant's answers. 4. To the best of my knowledge and belief the statements a nd declaration made by the Defendant are accurate and true a nd have been freely and voluntarily made. Dated this ____________ day of ______________________ ___, 20____. __________________________________ Attorney for the Defendant