To keep other people from seeing what you entered on your form, please press the Clear This Form button at the end of the form when finished. Notice: The court requires that this form be printed on lavender-colored paper. FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO PEOPLE vs. CASE NUMBER DEFENDANT PLEA OF GUILTY / NO CONTEST – MISDEMEANOR DOMESTIC VIOLENCE DA/CA/ # INSTRUCTIONS: Fill out this form if you wish to plead guilty or no contest to the charge(s) against you. Initial each applicable item only if you understand it. If you have any questions about the possible sentence, or the information on this form, ask your lawyer or the judge. I, the defendant in the above-entitled case, personally and/or by my attorney, declare as follows: 1. I am sober and my judgment is not impaired and I have not consumed any alcohol or other drug within the past 24 hours. 1. 2. I am entering a plea freely and voluntarily, without threat or fear to me or anyone closely related to me. 2. 3. I understand that a plea of No Contest is, for all purposes, the same as a plea of Guilty. 3. 4. PLEA. Of those charges now filed against me in this case, I plead to the following offenses and admit the prior convictions as follows: (GUILTY/NO CONTEST) 4. COUNT LIO CHARGE PRIORS Date of Conviction Charge Case Number _______________________________ _______________________________ 5. FACTUAL BASIS. I admit that on the dates charged, I (Describe facts as to each charge and allegation) 5. 6a. AGREEMENT. I have not been induced to enter the above plea by any promise or representation of any kind, except: 6a. SENTENCE TO COURT. People dismiss balance. Other: _______ DENY PROBATION. SENTENCE: days Releasable to Work Furlough/ Concurrent / GRANT PROBATION. CUSTODY: SERVE Book and release . Consecutive to case/counts . Imposition of sentence suspended for 3 / ____ years on the following terms: VNL and Execution of sentence suspended for 3 /____ years on the following terms: VNL and _____ days CTS STAYED on condition that Releasable to: Work Furlough / . Residential treatment program Concurrent / Consecutive to case/counts FINES/FEES: PAY $674 ($20 Crt Security Fee; $100 Restitution Fine; $400 DV Fund; $154 Criminal Justice Admin Fee) . PAY $_______ (total of $20 Court Security Fee for each additional count.) PAYMENT STAYED until DVRP completed. $100 Prob. Rev. Fine, suspend per PC1202.44. Reimburse County for appointed attorney if/ when able. RESTITUTION: PAY restitution to (Victim / VCGCB) . Hearing to be set if and when determined. PUBLIC SERVICE: PERFORM: _____ days PSWP _____ hours Volunteer Work. STAYED until DVRP completed. ATTEND AND COMPLETE: Substance Abuse Assessment _____ Parenting Classes 52-week DV Recovery Program Dual Track DV/SA Integrated DV/SA Individual Counseling__weeks/months. STOP Residential / Outpatient treatment alcohol / drug STAYED:________________________. Comply with Cal/Fed Firearms Prohibition on controlling, possessing, or having access to any firearm. Comply with terms of Protective Order including “stay away” terms. Other: . SDSC CRM-184 (Rev. 4/08) PLEA OF GUILTY/NO CONTEST – MISDEMEANOR DOMESTIC VIOLENCE Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com DEFENDANT 6b. FIREARMS. I CASE NUMBER do / do not 6b. own, possess, or have access to any firearm. (circle your answer) RIGHT TO A LAWYER 7a. I understand that I have the Constitutional right to be represented by a lawyer at all stages of the proceedings including sentencing. I can hire my own lawyer or the Court will appoint a lawyer for me if I cannot afford one. 7a. 7b. I understand that I have the right to be present in Court to enter my plea and for sentencing. I expressly authorize my lawyer to enter this plea on my behalf, in my absence. I understand that I must be personally present at the time of sentencing. 7b. CERTAIN CONSTITUTIONAL RIGHTS WHICH I GIVE UP I understand that as to all charges, allegations and prior convictions filed against me I also have the following Constitutional rights, which I now give up to enter my plea of Guilty/No Contest. 8. I have the right to a speedy and public trial by jury. I now give up this right. 8. 9. I have the right to confront and cross-examine all the witnesses against me. I now give up that right. 9. 10. I have the right to remain silent (unless I choose to testify on my own behalf). I now give up this right. 10. 11. I have the right to present evidence in my behalf and to have the Court subpoena my witnesses at no cost to me. I now give up this right. 11. CONSEQUENCES OF PLEA OF GUILTY OR NO CONTEST 12. I understand the possible consequences of entering a plea of Guilty or No Contest include a maximum sentence of up to ________ months/years(s) in jail and fine(s) of up to __________ plus additional consequences specified in any attached addendum, and any other reasonable conditions of probation, which could be for a maximum of 3/5 years. 12. 13. I understand that in addition to any fine imposed, the law requires the Court to add penalty assessments which will substantially increase the amount I must pay. In addition, I understand that I may be ordered to make restitution to the victim, if the offense involved a victim, or to a restitution fund. I understand that I shall be ordered to pay a mandatory restitution fine ($100 - $1,000) and a probation revocation restitution fine ($100 – $1,000) if probation is revoked and not reinstated. I understand I must file a revised financial declaration if there is any balance unpaid on restitution order or fine 120 days prior to release from probation. 13. 14. I understand that if I am not a U.S. citizen, this plea of Guilty or No Contest may result in my removal/ deportation, exclusion from admission to the U.S. and denial of naturalization. Additionally, if this plea is to any offense listed on page four of this form, then I will be deported, excluded from admission to the U.S., and denied naturalization. 14. 15. I understand that my plea of Guilty or No Contest in this case could result in revocation of my probation or parole in other cases and the imposition of consecutive sentences 15. 16. I understand and agree that probation terms concerning substance abuse treatment may be modified without a probation violation occurring. 16. OTHER WAIVERS 17. (Time for Sentence). I understand that I may not be sentenced earlier than six (6) hours, nor later than five (5) days after my plea. I give up this right, waive arraignment, and agree to be sentenced at this time. 17. 18. (Certain Appeal Rights). I give up my right to appeal the following: a) denial of my 1538.5 motion, and b) any sentence stipulated herein. 18. 19. (Harvey Waiver). The sentencing judge may consider my prior criminal history and the entire factual background of the case, including any unfiled, dismissed, or stricken charges or allegations or cases when granting probation, ordering restitution, or imposing sentence. 19. SDSC CRM-184 (Rev. 4/08) PLEA OF GUILTY/NO CONTEST – MISDEMEANOR DOMESTIC VIOLENCE Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com DEFENDANT CASE NUMBER 20. (Arbuckle Waiver). I give up my right to be sentenced by the judge who accepts this plea. 20. 21. (Judicial Officer). I agree that a duly appointed Commissioner or Temporary Judge may act as a Judge, accept this plea, impose sentence, and conduct any other post-conviction proceedings. 21. 22. (Evidence disposal). I give up my interest in all non-biological property/evidence impounded during the investigation of this case except ______________ and acknowledge that if I listed any property here, I must also file a claim with the impounding agency within 60 days after pronouncement of judgment or my ability to make a claim will expire. 22. I DECLARE UNDER PENALTY OF PERJURY, under the laws of the State of California, that: (a) I have read, understood, and initialed each applicable item above and any attached addendum; and (b) everything on the form and any attached addendum is true and correct. Date: Defendant’s signature: Defendant’s address: Street Defendant’s telephone no.: ( City State Zip ) ATTORNEY’S STATEMENT I, the attorney for the defendant in the above-entitled case, personally read and explained to the defendant the entire contents of this plea form and any addendum thereto. I discussed all charges and possible defenses with the defendant, and the consequences of this plea, including any immigration consequences. I personally observed the defendant fill in and initial each item, or read and initial each item to acknowledge his/her understanding and waivers. I observed the defendant date and sign this form and any addendum. I concur in the defendant’s plea and waiver of constitutional rights. Date: (Print Name) Attorney for Defendant (Signature) (Circle one: PD / APD / PCC / RETAINED) INTERPRETER’S STATEMENT (If Applicable) I, the interpreter in this proceeding, having been duly sworn, truly translated this form, and any attached addendum, and all the language. The defendant indicated questions therein to the defendant in the understanding of the contents of the form and then initialed and signed the form and any attached addendum. Date: (Print Name) Court Interpreter (Signature) PROSECUTOR’S STATEMENT The People of the State of California, plaintiff in the above-entitled criminal case, by and through its attorney concurs with the defendant’s plea of Guilty/No Contest as set forth above. Date: (Print Name) Deputy District Attorney/Deputy City Attorney (Signature) COURT’S FINDING AND ORDER The Court, having questioned the defendant/defendant’s attorney concerning the defendant’s plea of Guilty/No Contest and admissions of the prior convictions and allegations, if any, finds that: The defendant understands and voluntarily and intelligently waives his/her constitutional rights; the defendant’s plea and admissions are freely and voluntarily made; the defendant understands the nature of the charges and the consequences of the plea and admissions; and there is a factual basis for same. The Court accepts the defendant’s plea and admissions, and the defendant is convicted thereby. Date: Judge/Commissioner of the Superior Court SDSC CRM-184 (Rev. 4/08) PLEA OF GUILTY/NO CONTEST – MISDEMEANOR DOMESTIC VIOLENCE Page 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com DEFENDANT CASE NUMBER CERTAIN OFFENSES DEFINED AS MISDEMEANORS UNDER STATE LAW MAY BE CONSIDERED “AGGRAVATED FELONIES” UNDER FEDERAL LAW. ANY CONVICTION OF A NON-CITIZEN FOR AN “AGGRAVATED FELONY” AS DEFINED UNDER 8 U.S.C. § 1101(a)(43) WILL RESULT IN REMOVAL/DEPORTATION, EXCLUSION AND DENIAL OF NATURALIZATION. “AGGRAVATED FELONIES” include, but are not limited to, the following crimes and any attempt or conspiracy to commit such crimes, even if the conviction is a misdemeanor under state law. (NOTE: Conviction of an aggravated felony is not the exclusive basis for which a defendant may or will be deported.) 1. ANY CRIME OF VIOLENCE* (Includes any offense that has as an element the use, attempted use, or threatened use of physical force against the person or property of another (18 U.S.C. § 16)) 2. BURGLARY (Except a vehicle or vessel, unless used as a residence)* 3. CHILD PORNOGRAPHY OFFENSES 4. CONTROLLED SUBSTANCES** a) MISDEMEANOR POSSESSION OF ANY CONTROLLED SUBSTANCE when the defendant has previously been convicted of a drug related offense b) POSSESSION FOR SALE OF CERTAIN CONTROLLED SUBSTANCES c) SALE OF CERTAIN CONTROLLED SUBSTANCES d) TRANSPORTATION OF CERTAIN CONTROLLED SUBSTANCES e) MANUFACTURE/DISTRIBUTION OF CERTAIN CONTROLLED SUBSTANCES 5. FORGERY* 6. FRAUD (where loss to victim or victims exceeds $10,000) 7. MONEY LAUNDERING (If amount over $10,000) 8. PERJURY/SUBORNATION of Perjury or Bribery of a Witness 9. PIMPING/PANDERING/OPERATING A PROSTITUTION BUSINESS 10. STATUTORY RAPE (“Unlawful Sexual Intercourse”) 11. RECEIVING STOLEN PROPERTY * 12. SEXUAL ABUSE OF A MINOR (Touching is not required, e.g. Indecent Exposure) 13. THEFT (Any type or amount)* 14. TRAFFICKING IN VEHICLES WITH ALTERED VINS* *Where the term imposed is at least one year, whether or not any or all of that term is stayed or suspended at the time of sentencing. ** See 21 U.S.C. § 802. Note, however, federal and state statutes defining controlled substances are not identical. SDSC CRM-184 (Rev. 4/08) Print This Form PLEA OF GUILTY/NO CONTEST – MISDEMEANOR DOMESTIC VIOLENCE For your protection and privacy, please press the Clear This Form button after you have printed the form Page 4 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Clear This Form