Fill and Sign the Charge ID S Form

THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) Charge ID #s: ENTRY OF NOT GUILTY PLEA AND WAIVER OF ARRAIGNMENT The undersigned defendant in the above -captioned criminal matter(s) hereby certifies that: 1. I have received a copy of the charging document(s) numbered as followed for the above entitled cases(s): 2. I have read the charging document(s) and discussed it (them) with my attorney. 3. My attorney has advised me as to the nature of the crime(s) charged and as to the punishment for the alleged offense(s) as set forth by statute. I understand the substance of the charge(s) and am aware of the punishment provided. 4. My name is co rrectly stated in the charging document (s) Yes No 5. (a) My home address is: (b) My present mailing address is: (c) My home telephone is: (d) My date of birth is: 6. My New Hampshire attorney is: 7. In view of the foregoing and with full knowledge of my rights, I hereby waive arraignment and enter (a) plea(s) of Not Guilty to the charging document (s). 8. A bail hearing is necessary. 9. The defendant agrees to all the terms contained in the attached bail agreement. 10. A negotiated plea agreement has been reached. A Notice of Intent to Plea is attached. Date Defendant I hereby certify that I have dis cussed the charging document (s) with the defendant on , and believe that the defendant understands the nature of the charge(s) and the punishment therefore, which I have also explained to the defendant. Date Attorney for the Defendant The State agrees to all the terms contained in the attached bail agreement. Date County Attorney NHJB-2309 -S (11/17 /2014)