Criminal Change of Plea Form

CRIMINAL CHANGE OF PLEA FORM

Court:   County:

Case Number:   Defendant Name:

Defendant Date of Birth:   Defense Counsel:

Prosecuting Attorney:

RECITALS

WHEREAS, the above-captioned matter is currently pending in this Court and the Defendant is charged by complaint, information, or indictment with one or more criminal offenses specified below; and

WHEREAS, the Defendant requests to change the plea from not guilty to a plea of guilty or no contest and has discussed the plea, the facts, and the consequences with counsel; and

WHEREAS, the Prosecuting Attorney has reviewed the factual basis for the plea and advises the Court of the State's position regarding the plea and any recommended disposition;

NOW, THEREFORE

The parties hereby submit the following statements, acknowledgements, and stipulations to the Court for acceptance of the change of plea.

1. CHARGES AND PLEA

Charged Offense(s) (statute or description):

Change of Plea to be entered by Defendant (select one):    Guilty    No Contest (Nolo Contendere)

2. ADVISEMENT AND WAIVER OF RIGHTS

The Defendant acknowledges that the following constitutional and statutory rights have been explained and that the Defendant understands and voluntarily gives up these rights by entering the plea:

1. Right to a jury trial and to have the guilt of each alleged offense established beyond a reasonable doubt;
2. Right to confront and cross-examine prosecution witnesses and to compel the attendance of witnesses in the Defendant's favor;
3. Right to testify or remain silent and that any statement made may be used against the Defendant;
4. Right to appellate review as provided by law and any waivers of appeal are expressly stated herein.

The Defendant acknowledges that counsel for the Defendant has advised fully of the nature of the charges, possible defenses, and the consequences of the plea, including potential sentencing range and collateral consequences such as immigration consequences, registration obligations, and civil disabilities.

3. FACTUAL BASIS

The Prosecuting Attorney states that the following facts constitute a sufficient factual basis for the plea (describe succinctly):

The Defendant affirms that the factual basis as stated above is true to the Defendant's knowledge or that the Defendant agrees such facts are sufficient to support the plea.

4. AGREEMENTS REGARDING SENTENCING

Sentencing recommendations or agreements (if any):

The Defendant understands that any recommendations are not binding on the Court unless the Court expressly accepts them. The Court retains discretion to impose any lawful sentence.

5. RESTITUTION, FINES, AND COSTS

Restitution owed to victims (amount or terms):

The Defendant acknowledges that fines, assessments, fees, and court costs may be imposed in addition to any custodial sentence and that failure to pay may result in additional legal consequences as prescribed by law.

6. VOLUNTARINESS AND COMPETENCY

The Defendant affirms that the plea is made knowingly, voluntarily, and without coercion, promise of leniency beyond that stated, or improper threats. The Defendant further affirms that the Defendant is competent to enter this plea and has the capacity to understand these proceedings.

If mental health, medication, or other competency concerns exist, list here:

7. IMMIGRATION CONSEQUENCES

The Defendant has been advised that a plea of guilty or no contest may have immigration consequences, including but not limited to deportation, exclusion from admission, or denial of naturalization. The Defendant acknowledges receipt of such advisement.

8. WITHDRAWAL OF PLEA

The Defendant acknowledges that the right to withdraw a plea is limited by statute and court rule and that a plea may be withdrawn only for good cause as determined by the Court. Any request to withdraw must be made in accordance with applicable law.

9. JUDICIAL ACCEPTANCE

The Court will inquire of the Defendant and counsel on the record regarding the voluntariness, factual basis, and understanding of consequences. If the Court finds the plea is lawful and supported by a factual basis, the Court will enter judgment of conviction.

10. NOTICES AND SERVICE

Notices required under this agreement shall be provided in writing to counsel or the party's last known address on the record. Service by mail is complete upon deposit in the United States mail with proper postage.

11. AMENDMENT, WAIVER, ENTIRE AGREEMENT

This document constitutes the entire change-of-plea agreement and understanding between the parties as expressed herein. Any amendment or waiver must be in writing and signed by the Defendant, defense counsel, and the Prosecuting Attorney and approved by the Court to be effective.

12. SEVERABILITY; GOVERNING LAW

If any provision of this change-of-plea form is held invalid or unenforceable, such invalidity shall not affect the remaining provisions which shall continue in full force and effect. This document and the plea entered pursuant to it shall be governed by the laws of the jurisdiction of the Court named above.

13. COUNTERPARTS

This form may be executed in counterparts, each of which shall be deemed an original but all of which together shall constitute one and the same instrument.

CERTIFICATIONS

By signing below, the Defendant certifies under penalty of perjury that the foregoing statements are true and correct; that the plea is entered voluntarily and with full knowledge of the consequences; and that the Defendant understands the rights being waived. The Prosecuting Attorney certifies that the factual basis set forth is true to the Prosecuting Attorney's knowledge and that the plea is recommended in accordance with the terms stated above.

ADDITIONAL INFORMATION

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