Exempt from VRA Certif. CR-316 (11/18)(cs) APPLICATION FOR CHANGE OF PLEA HEARING IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA AT STATE OF ALASKA ) ) CASE NO. CR ) ) Plaintiff, ) APPLICATION FOR vs. ) CHANGE OF PLEA HEARING ) Defendant, ) Hearing Date set am pm ) before Judicial Officer DOB: ) in Ctrm by (Clerk/Judicial Officer) Trial date currently set Hearing date requested: 1. This case involves a crime victim: Yes No 2. I certify that I notified the prosecutor of this application by mail fax in person phone e-mail on (date) at a.m./p.m. 3. Is defendant in custody? Yes No If yes, where? 4. In this case, I am: representing myself an attorney representing the defendant. For Attorney Only: PD DA OPA DLG MA Private Attorney 5. I request a change of plea hearing in District Court Superior Court, and I request do not request to be sentenced at the same time. I will will not waive presentence report. 7. The State has has not agreed to waive presentence report. 8. I am charged with felony(ies) but the plea and sentencing will be to misdemeanors only. 9. Based on the plea agreement, I will have served my time by: the change of plea hearing . 10. This plea hearing will resolve (list all case numbers): 11. Terms of Agreement: 12. Other: Notice to Applicant: If you are requesting a same-day or next-day hearing, contact your local courthouse to determine whether this is possible. For example, Anchorage next-day hearing requests must be received by noon the previous business day. Date Signature of Applicant (Defendant or Attorney) Printed Name of Applicant and Attorney Bar Number I certify that on a copy of this document with hearing date Phone Number Fax Number was sent to: DA Def./Def. Atty. Clerk: American LegalNet, Inc. www.FormsWorkFlow.com