Fill and Sign the To Be Used Only If Upon Conviction the Form

9-401 [For use with District Court Rule 5-301] STATE OF NEW MEXICO COUNTY OF___________________ __________________________ COURT No. ___________ STATE OF NEW MEXICO v. ________________________________, Defendant WAIVER OF COUNSEL (To be used only if, upon conviction, the defendant may be deprived of liberty) I understand that I am charged with the following offense[s]:_________________ _______________________________________________________________________ __________________________________________________ which (strike inapplicable words or parts) [is] [are] misdemeanors under the law and that if I am found guilty I can be given a severe punishment, including imprisonment in the [New Mexico state penitentiary] [____________________ [city] [county] jail] and a fine. I understand that under the Constitutions of the United States and the State of New Mexico, I have the right to be represented by a lawyer at all stages of the criminal case -- before trial, at the trial itself, during proceedings to determine what sentence should be imposed if I am found guilty, and any appeal. I understand that if I am unable, without undue hardship, to pay for all or a part of the expense of legal representation from available present income and assets, a lawyer will be furnished for me free of charge. After reading and understanding all of the above, I hereby give up my rights to a lawyer in this case, and to have a lawyer furnished for me free of charge if I cannot afford one. DO NOT SIGN THIS FORM IF YOU WANT AN ATTORNEY. DO NOT SIGN THIS FORM UNLESS YOU HAVE READ IT AND UNDERSTAND IT. ______________________________ Defendant 2 I find that the defendant, knowingly, voluntarily and intelligently with full awareness of the right to counsel, has waived the right to counsel. ______________________________ Judge Date: ________________________ [As amended, effective January 1, 1999.]