Fill and Sign the Application to Plead Guilty on Form

State of A labam a Unified Judicial System Form CR-3 Rev . 4/99 APPLICATION TO PLEAD GUILTY ON INFORMATION Case Number IN T HE ____________________________________CO URT OF ______________________________________, ALABAMA (Circuit, District) (Name of County) ST ATE OF ALABAMA v.________________________________________________________________________\ _________ Defendant Comes the defendant in the abov e-sty led cause and informs t he Court that the defendant: 1. Was arrested for the offense of _________________________________________________________\ ______ on ________________________________; date 2. Has been bound over to the Circuit Court to await action of the Grand Jury, is confined in jail awaiting a preliminary hearing, or is confined in jail having waived presentation to the Grand Jury. 3. desires to plead guilty in this case; 4. … is represent ed by _______________________________________________________________________\ , an attorney ; OR … Is unable to obtain counsel and desires that this Court appoint counsel to represent him/her in this cause; and 5. Is charged with______________________________________________________________________\ _, w hich is a non-capital felony offense. Wherefore, after obtai ning the advise of counsel, defendant asks that the Court take jurisdiction of this cause and direct the District Attorney of this circuit to prefer and file an information against the defendant under the provisions of Section 15- 15-20.1, Ala. Code 1975. ____________________________ __________________________________________________________ Date Defendant IDENTIFICA TION OF DEFENDA NT Name of Defendant Telephone Number Address City State Zip Code Social Security Number Date of Birth Age Race Sex Height Weight Hair Eyes Other Name of Employ er Employ er’s Telephone Number Address City State Zip Code