Fill and Sign the Chins Acknowlegdment and Waiver of Rights Form

THE ST A TE O F NEW H A M PSHIRE JUDI CI AL BR AN C H Cour t Na m e: Ca se Nam e: Ca se Num ber: (if k now n) CHI NS ACKNOWLEDGM ENT AND WA IVER OF R IGHT S I , , m y attor ney bein g , know ingly, inte llige ntly, f reely a nd voluntarily m ake the following sta tem ents w hich I un de rsta nd ap ply to e ach and ev er y juveni le peti tion ( if th er e i s mor e tha n on e) to w hich I ad mi t (which means to "pl ead tr ue "). I und er stan d I hav e be en char ged w ith th e fol lowing act( s): I UNDERST AND that I do not hav e to ad mit to the act(s) and that ev en a fter sig ning this Acknowledg ment and W aiver of Rig hts, I still do not hav e to ad mit to the act(s). I UNDERST AND that by adm itting to the act(s ), I am giving up the f ollowing constitutional rights: MY RIGH T to a speedy tr ial. MY RIGH T to see, hea r and q uesti on al l witne sses ag ainst me and q uesti on them my sel f or thr oug h my lawyer. MY RIGH T to keep si lent and not testi fy ag ainst my sel f, if I choose, and to not hav e my sil ence used ag ainst me. MY RIGH T to hav e the j udg e or der into cour t al l evidence and w itness es i n my favor. MY RIGH T not to be found i n need of ser vices ex cept b y pr oof bey on d a r easonabl e do ubt o n al l elements o f the char ge(s), which hav e been ex plained to me by my law yer. MY RIGH T to hav e the C our t keep out ev idence or any conf essi ons w hich may hav e been obtai ned i n violati on of my consti tuti onal rights. MY RIGH T to appeal to the Supr em e C our t, on questi ons of law, if the peti tion i s foun d to be true. MY RIGH T to appeal to the Supr em e C our t, on questi on of law, if the Peti tion i s foun d to be t rue. I GIVE U P ALL THE A BOVE R IGH TS OF M Y O W N FR EE W ILL. I UNDERST AND that I am ad mitting to the truth o f the act(s) in the juvenile petition(s), and that if the C our t accepts my admi ssi on I may be foun d to be i n ne ed o f ser vices. I under stand my case w ill be given to a Juv enil e Servi ce Off icer for a backg round i nvestig ati on to be r eviewed by the Judge be fore I am foun d to be in need of ser vices. This repor t may contai n a r ecom mendati on for that di sp osi tion. NHJB-2218-DF (12/06/2006) Page 1 of 2 (formerly AOC 308-008/045) Case Name: Case Nu mber: CHINS ACKNOW LEDGEMENT AND W AIVER OF RI GHT S I AM AD MITTING to th e act( s) because the co ntent( s) of the juveni le peti tion( s) is(are) true. I admi t that I did the act( s) charg ed i n the j uvenil e peti tion( s). N o force has been use d upo n m e. N o pr omi ses hav e been m ade to me by any member of the pol ice depar tment, pr osecutor or an yone el se in an e ffort to hav e m e adm it to the act( s) except as follow s: I UNDERST AND that the Court does not h ave to follow the recom mendation o f th e police, pr osecutor , Juv enil e Probati on and Par ole O fficer or any one el se as t o recomme nded ser vices. I UNDERST AND that under certain circum stanc es, if the Court do es n ot follow an y recommend ati on, I ma y be abl e to take back my pl ea of tr ue a nd ha ve a tr ial. I UNDE RS TAND th at, with in th e lim its o f th e law, th e Ju dge m ay order a ny se rvice s s/h e feels a re fair. M y attor ney, whos e ser vices I am sati sfied w ith, has ex plained to me th e penal ties that the j udg e may giv e me as di sposi tion f or the act( s) I have admi tted, i ncludi ng pay ing a f ine up to $250. 00; pay ing for the dam ag e I di d; putti ng me on condi tiona l release unti l I am 18 y ear s ol d; r etur ning me to my par ents, g uar dian or custodi an; sendi ng me to a g roup home, cr isis home or shel ter car e hom e; or sendi ng me to counsel ing. I UNDE RS TAND th at if I a m foun d to be in need of se rvice s for a ny offense in volving th e sa le, possessi on, use or abu se of alcohol , or of a co ntr olled dr ug or drug an alog , the C our t may and the Director of the D ivision of M otor Vehi cles shal l revoke or den y me a dr iver 's license f or not l ess than 90 day s or mor e than one year for a f irst offense and not l ess than si x m onths or greater than tw o years f or a subseq uent o ffense. I do not h ave any quest ions at thi s time o f my attor ney or an yone el se. If ther e ar e any questi ons of the C our t or if ther e i s anything I woul d l ike to say bef or e di sposi tion o f thi s case, my attor ney will let the Cour t know at the ti me of my admi ssi on to the act( s). I under stand tha t I may ask to hav e a copy of thi s Acknow ledg ment and W aiver of R ights f orm. Date J uvenile P arent / Guardian / Custodian As cou nsel for the juveni le, I hav e th or oug hly ex plained t o th e j uveni le al l th e a bov e, i ncluding the natur e of the charge, the el em ents of the act( s) w hich the St ate mus t pr ov e bey ond a r easo nabl e dou bt, and the m aximu m a nd mi nimu m di sp ositional or ders. I bel ieve th e j uveni le fully und er stands the me ani ng of thi s Ac know ledg ment and W aiver of R ights, th at s/ he has t he me ntal capacity to ev aluate t hese rights; I bel ieve tha t s/ he d oes und er stan d a nd ev aluate t hes e r ights an d d oes know ing ly, intellig ently and v olunt arily waive a ll of his/h er rig hts as se t forth herei n. Date A ttorney for the Juvenile The u nder signed Judg e has aske d t he j uveni le if s/h e (1) understan ds th e ch ar ges ag ainst him/h er; (2) under stan ds th e p ossi ble p enalties; a nd ( 3) und er stan ds the fact tha t s/h e is giving up his/her co nsti tution al rights. The und er signed finds t hat the juveni le has th e m ent al ca paci ty to ev aluate t his Ackn ow ledg m ent an d W aiver o f Rig hts and finds t hat s /he d oes k now ing ly, intellig ently and v olunt ar ily waive those r ights. Dat e Sign ature of Judg e Printed Nam e of Judg e NHJB-2218-DF (12/06/2006) (formerly AOC 308-008/045) Page 2 of 2