FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO PEOPLE vs. Defendant PLEA OF GUILTY/NO CONTEST ­ MISDEMEANOR DOMESTIC VIOLENCE Case # DA/CA/ # INSTRUCTIONS: Fill out this form if you wish to plead guilty or no contest to charges 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 attorney or the judge. I, the defendant in the above-entitled case, personally and/or by my attorney, declare as follows: 1. 2. 3. 4. I am sober, my judgment is not impaired, and I have not consumed any alcohol or other drug within the past 24 hours. I am entering a plea freely and voluntarily, without threat or fear to me or anyone closely related to me. I understand that a plea of No Contest is, for all purposes, the same as a plea of Guilty. PLEA. Of those charges now filed against me in this case, I plead to the following offenses and admit the prior convictions as follows: COUNT LIO CHARGE Date of Conviction 1. 2. 3. 4. (GUILTY/NO CONTEST) PRIORS 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: SENTENCE TO COURT. People dismiss balance. Other: _______ DENY PROBATION. SENTENCE: days Releasable to Work Furlough/ Concurrent / Consecutive to case/counts 6a. . . GRANT PROBATION. CUSTODY: SERVE Book and release 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 $ including the following: $_______ Court Ops. Assessment (PC1465.8) ($40 per count) $_______ Restitution Fund Fine (PC1202.4(b)(1)) ($150-$1,000) $_______ Domestic Violence Fund Fee (PC1203.097) (Min. $500) $_______ Criminal Conviction Assessment (GC70373) ($30 per count) $_______ Crim. Justice Admin. Fee (GC29550 et seq) ($154 if booked) . PAYMENT STAYED until DVRP completed. $______ Prob. Rev. Rest. 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 PSP _____ hours Volunteer Work. STAYED until DVRP completed. ATTEND AND COMPLETE: Substance Abuse Assessment _____ Parenting Classes _____ Elder Abuse 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: . 6b. FIREARMS. I SDSC CRM-184 (Rev. 1/14) do do not own, possess, or have access to any firearm. 6b. Page 1 of 4 PLEA OF GUILTY/NO CONTEST ­ MISDEMEANOR DOMESTIC VIOLENCE American LegalNet, Inc. www.FormsWorkFlow.com Defendant: Case # RIGHT TO AN ATTORNEY 7a. I understand that I have the Constitutional right to be represented by an attorney at all stages of the proceedings including sentencing. I can hire my own attorney or the court will appoint an attorney for me if I cannot afford one. 7b. I understand that I have the right to be present in court to enter my plea and for sentencing. I expressly authorize my attorney to enter this plea on my behalf, in my absence. I understand that I must be personally present at the time of sentencing. 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. 9. I have the right to confront and cross-examine all the witnesses against me. I now give up this right. 10. I have the right to remain silent (unless I choose to testify on my own behalf). I now give up this right. 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. 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. 13. My attorney has explained to me that other possible consequences of this plea may be (circle appropriate consequences): (a) lifetime registration as a sex offender; (b) registration as a narcotics offender; (c) limited local custody credits (290/serious/prior); (d) qualified for sentencing under PC § 1170(h)(3) in future cases. 14. 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 and a probation revocation restitution fine of the same amount if probation is revoked and not reinstated. I understand I must file a revised financial declaration if there is any balance unpaid on a restitution order or fine 120 days prior to release from probation. 15. 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. 16. I understand that my plea of Guilty or No Contest in this case could result in revocation of my probation, mandatory supervision, post-release supervision, or parole in other cases and the imposition of consecutive sentences. 17. I understand and agree that pro