STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE 17TH JUDICIAL CIRCUIT COUNTY, ILLINOIS PEOPLE OF THE STATE OF ILLINOIS vs. Defendant ) ) ) ) ) ) ) ) CASE NO. (S) CHARGE (S) JURY WAIVER I hereby give up my right to a trial by jury in the above listed charges and hereby consent to a trial before a judge without a jury and in so doing I state the following: 1. That I have been informed of and understand the nature of the charge(s). 2. That I know and have been told of the possible penalties for my charge(s). 3. That I know I have the right to an attorney and that if I cannot afford one, the court will appoint an attorney to represent me through all stages of my criminal charge(s). That if I do not have an attorney with me when I sign this, I understand I am giving up my right to have an attorney assist me in deciding whether I should be tried by a jury or by a judge without a jury. 4. That I know I have the right to a trial by a jury on all of my charges, but that I give up that right and request a trial by a judge without a jury. 5. That I am signing this voluntarily and of my own free will. Date: Defendant A-3 APPENDIX C 04/95 2002 © American LegalNet, Inc.