State of Minnesota County Judicial District: Court File Number: Case Type: District Court Criminal State of Minnesota, Plaintiff vs. Defendant I understand: 1. I am charged with committing the offense(s) described in the complaint, citation, or ticket. If I have not received a written complaint describing the charges against me, I may request one. 2. The maximum sentence for a misdemeanor offense is a fine of $1,000 and applicable surcharges, 90 days in jail, or both. 3. I can be charged with a crime if I fail to appear in Court when I am told or notified of a Court date. The punishment for failure to appear can include a fine, jail, or both. 4. I have the right to be represented by an attorney at all times and an attorney will be appointed without cost to me if I cannot afford to pay for an attorney. 5. I have the following constitutional rights: a. for the case to be continued for me to obtain or speak to an attorney. b. to a trial by the Court, or by a jury of six persons, in which I am presumed innocent until proven guilty by the state beyond a reasonable doubt. c. to remain silent at all times, including at trial. Anything I say may be used against me. d. the right to confront and cross-examine all witnesses. e. the right to subpoena witnesses on my behalf. 6. I (check one): a. request a court-appointed attorney and have completed a form regarding my income, property, and expenses. b. request a continuance to obtain or speak to an attorney. c. do not request a court-appointed attorney and waive (give up) the right to an attorney. d. have retained my own attorney. Your attorney: Street Address: City/State/Zip: Telephone: ( E-mail address: Misdemeanor Statement of Rights ) If you have checked box 6a or 6b, STOP HERE: DATE AND SIGN THIS FORM. CRM204 State ENG Rev 07/15-R www.mncourts.gov/forms Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 7. I (check a. or b.): a. wish to plead guilty to the offense charged and give up my right to trial on this charge and my right to be represented by an attorney. b. wish to plead not guilty to the offense charged and [check (1) or (2)] (1) request a jury trial. (2) waive (give up) the right to a jury trial. Dated: Signature Your Name: Street Address: City/State/Zip: Telephone: ( E-mail address: ) Date of Birth CRM204 State ENG Rev 07/15-R www.mncourts.gov/forms Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com