IN THE DISTRICT COURT OF LANCASTER COUNTY, NEBRASKA STATE OF NEBRASKA, Plaintiff, v. __________________________________, Defendant. ) ) ) ) ) ) ) ) ) CASE CR ___ - ______ WAIVER OF PRELIMINARY HEARING AND WAIVER OF PHYSICAL APPEARANCE WAIVER: I, the Defendant named in the above-entitled action, understand that I have been ordered to appear for a preliminary hearing as follows: Date: _________________, Time: _____________, Courtroom # __________. I further understand that I have a right to a preliminary hearing at that time to determine if there is probable cause to believe that I violated the terms and conditions of my probation as alleged in the motion for revocation of my probation filed by the State of Nebraska in this matter. I have discussed this right with counsel and I fully understand my right to such a hearing. I hereby freely, voluntarily, knowingly and intelligently waive the right to a preliminary hearing. I request the court accept my waiver as set forth herein. TRIAL: I agree to personally appear in this matter for arraignment/trial as follows: Date: ______________________ Time: _____________________, ____. M. Place: Courtroom # _________, Judge ___________________ 575 S. 10th, Lincoln, NE. (Counsel shall call the Judge assigned to this case for the hearing date and time prior to execution by the Defendant.) I understand that my failure to personally appear for trial could result in a bench warrant for my arrest being issued and I could be charged with the crime of Failure To Appear. DATED:__________________ Defendant's signature:______________________________ American LegalNet, Inc. www.FormsWorkFlow.com STATEMENT OF COUNSEL I am the Defendant's attorney of record in this matter. I have advised the Defendant of the right to have a Preliminary Hearing in this matter and reviewed this document with the Defendant and have explained its contents. I represent that the Defendant has freely and voluntarily waived the right to a preliminary hearing and knows of the next date s/he is set to appear. I represent that the Defendant signed this waiver. DATED:____________ Attorney's signature: _________________________________ Attorney's Bar #: ___________________ CERTIFICATE OF SERVICE I hereby certify that a copy of this waiver was served upon ________________. Deputy Lancaster County Attorney, 575 South 10th Street, Lincoln, Nebraska 68508, this _____ day of ____________________, 20_____. ________________________________________________ Attorney for the Defendant CRIM - 1: WAIVER OF PRELIMINARY HEARING AND WAIVER OF APPEARANCE, Rev 2/7/13 American LegalNet, Inc. www.FormsWorkFlow.com