ATTORNEY OR PARTY WITHOUT ATTORNEY ( Name, State Bar number, and address ): TELEPHONE NO: FAX NO. (Optional) E - MAIL ADDRESS ( Optional ): ATTORNEY FOR ( Name ): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CRUZ 701 Ocean Street, Room 120 Santa Cruz, CA 95060 Santa Cruz Branch PEOPLE OF THE STATE OF CALIFORNIA vs. DEFENDANT: ADVISEMENT OF RIGHTS, WAIVER AND PLEA FORM Deferred Entry of Judgment (Penal Code 247 1000 et seq. ) CASE NUMBER: DEPARTMENT: Page 1 of 5 Penal Code 247 1000 SUPCR 1108 Form Adopted for OPTIONAL Use Superior Court of Santa Cruz County SUP CR 1108 Rev. 11 /0 2 /1 8 ADVISEMENT OF RIGHTS, WAIVER AND PLEA FORM INSTRUCTIONS Fill out this form if you wish to plead guilty to the charges against you in order to participate in the Deferred Entry of Judgment Program (DEJ Program). If you successfully complete the requirements of the DEJ Program as directed by the Court, your case will be dismissed. If you do not successfully complete these requirements, the Court will enter judgment based on your guilty plea and the sentence will be impose d in your case. Initial the box for each applicable item only if you understand it, and sign and date the form on page 4 . If you have questions about your case, the possible sentence, or the information on this form, ask your attorney or the judge. Fill o ut this form if you wis h to plead guilty to the charges against you. Initial the box for each applicable item only if you understand it, and sign and date the form on page 5 . If you have any questions about your case, the possible sentence, or the inform ation on this form, ask your attorney or the judge. RIGHT TO AN ATTORNEY INITIALS 1. I understand that I have the right to be represented by an attorney throughout the proceedings. I understand that the Court will appoint a free attorney for me if I cannot afford to hire one, but at the end of the case, I may be asked to pay all or part of the cost of that attorney, if I can afford it. I understand that there are dangers and disadvantages to giving up my right to an attorney, and that it is almost alw ays unwise to represent myself. 1. NATURE OF THE CHARGES ( Complete all items you are charged with.) 2. I understand that I am charged with the following offense(s): TYPE OF OFFENSE(S) AND SECTION NUMBER(S) 2. 3. If applicable - I understand that I am also charged with having the following prior conviction(s): (Note - Prior conviction(s) must not be for offenses involving a controlled substance.) LIST OFFENSE(S) AND SECTION NUMB ER(S) 3. 4. If applicable - I understand that I am also charged with violating the probation order(s ) in the following case(s): LIST OFFENSE(S) AND SECTION NUMBER(S) 4. 5. I understand the charge(s) against me, and the possible pleas and defenses. 5. American LegalNet, Inc. www.FormsWorkFlow.com PEOPLE OF THE STATE OF CALIFORNIA v s . DEFENDANT : CASE NUMBER: Page 2 of 5 Penal Code 247 1000 Form Adopted for OPTIONAL Use Superior Court of Santa Cruz County SUP CR 1108 Rev. 11/02/18 ADVISEMENT OF RIGHTS, WAIVER AND PLEA FORM CONSTITUTIONAL RIGHTS 6. RIGHT TO A JURY TRIAL - I understand that I have the right to a speedy, public jury trial. At the trial, I would be presumed innocent, and I could not be convicted unless 12 impartial jurors were convinced of my guilt beyond a reasonable doubt. 6. 7. RIGHT TO CONFRONT AND CROSS - EXAMINE WITNESSES - I understand that I have the right to confront and cross - examine all witnesses testifying against me. 7. 8. RIGHT AGAINST SELF - INCRIMINATION - I understand that I have the right to remain silent and not incriminate myself, and the right to testify on my own behalf. I understand that by pleading guilty, or admitting prior conviction(s) or probation violation(s), I am incriminating myself. 8. 9. RIGHT TO PRODUCE EVIDENCE - I understand that I have the right to present evidence and to have the Court issue subpoenas to bring into court all witnesses and evidence favorable t o me, at no cost to me. 9. PRIOR CONVICTIONS AND PROBATION VIOLATIONS 10. If applicable - I understand that I have all of the above constitutional rights for all of the charges against me, including any charged prior convictions or probation violations. However, for a charge of violating probation, I do not have the right to a jury trial, although I do have the right to a hearing before a judge. (Note - Please complete No. 31 on page 3.) 10. SPEEDY PRELIMINARY HEARING (For charged felony offenses only) 11. If applicable - I understand that if I am charged with a felony, I have a statutory right to a preliminary hearing, and a right that this hearing be held within a specified period of time. I would also have all of the above constitutional rights at the hearing, except that it would be conducted before a judge, rather than before a jury. (Note - Please complete No. 17 below.). 11. WAIVER OF RIGHTS Understanding all of the above, for all of the charges in this case , including any prior convictions or probation violations , which may be presented against me at my trial (and preliminary hearing) : 1 2 . I give up my right to an attorney, and I choose to represent myself. (Does not apply if you have an attorney.) 12 . 13 . I give up my right to a jury trial . (Does not apply to charged probation violations or to preliminary hearing) 13 . 1 4 . I give up my right to confront and cross - examine witnesses. 14 . 1 5 . I give up my right to remain silent and to not incriminate myself. 1 5 . 16 . I give up my right to produce evidence and witnesses on my own behalf. 16 . 1 7 . If applicable - I give up my right to a preliminary hearing before a judge as to any felony offenses. I also give up my right to have that hearing held within the specified period . 1 7 . PARTICIPATION IN DEFERRED ENTRY OF JUDGMENT (DEJ) PROGRAM 18. I understand that as part of the DEJ Program, I will be required to successfully complete a drug program for a period of between 18 months to 3 years, as determined by the Court. I will also be required to pay a drug program fee, depending on my abilit y to pay. 18 . 19. I understand that the Court will order me to pay a DEJ restitution fee. Depending on my ability to pay, the Court will also order me to pay administrative fees of up to $300 if the offense is a misdemeanor, or up to $500 if the offense is a felony, and to reimburse the probation department for the reasonable costs of program investigation or progress reports filed with the Court. 19 . 20. I understand that I may be required to undergo urine analysis to test for the presence of drugs, but the results will not be admissible as the basis of any new criminal prosecution or proceeding. 2 0 . American LegalNet, Inc. www.FormsWorkFlow.com PEOPLE OF THE STATE OF CALIFORNIA v s . DEFENDANT : CASE NUMBER: Page 3 of 5 Penal Code 247 1000 Form Adopted for OPTIONAL Use Superior Court of Santa Cruz County SUP CR 1108 Rev. 11/02/18 ADVISEMENT OF RIGHTS, WAIVER AND PLEA FORM PARTICIPATION IN DEJ PROGRAM (Continued) 21. I understand that if I successfully complete the DEJ Program, my guilty plea will not constitute a conviction, unless a judgment of guilt is entered as specified in number 22 below. (But see numbers 24 - 25 .) I must still disclose my arrest upon request if I apply for a position as a peace officer. If I plead guilty based on a forged or altered drug prescription (H & S Code 247 11368), I may still be subject to disciplinary action or denial of a license by an administrative agency. INITIALS 21. 22. I understand that the Court may, after notice to me, schedule a hearing for sentencing and, thereafter, enter judgment if: (1) I perform unsatisfactorily in the DEJ Program; or (2) I am convicted of any felony; or (3) I am convicted of any misdemeanor indicating a propensity for violence; or (4) I engage in any other criminal conduct rendering me unsuitable for deferred entry of judgment. 22. 23. I understand that I have a right to wait from 6 hours to 5 days prior to the pronouncement of the judgment for a misdemeanor, and to wait up to a maximum of 20 judicial days for a felony. I give up this right in order to participate in the DEJ Program. 23. 24. I understan