IN THE JUSTICE COURT OF SPARKS TOWNSHIP, IN AND FOR THE COUNTY OF WASHOE, STATE OF NEVADA THE STATE OF NEVADA DOMESTIC VIOLENCE WAIVER OF RIGHTS Plaintiff, (1998) vs. ) Case No.: ______________________ ) ) Dept. No.: ______________________ ) ___________________________________,) Defendant Defendants Initials ______ I understand I have been charged with battery constituting domestic violence in having willfully and unlawfully committed an act of force or violence upon my spouse, former spouse, any other person to whom I am related by blood or marriage, a person with whom I am or was actually residing, a person with whom I have had or am having a dating relationship, a person with whom I have a child in common, my minor child or the minor child of any of these persons, ______ on the ____________________ day of __________________, 20___, in violation of WCC 53.110 and NRS 33.018. ______ I understand the State must prove the elements in the above paragraph beyond a reasonable doubt. ______ I understand the State will use this and any other constitutionally valid prior conviction of this type of offense to enhance the penalty for any subsequent offense. ______ I understand the following possible punishments apply: ST 1 . Ofense: At least 2 days in jail but not more that 6 months, at least 48 hours but not more than 120 hours of community service, a fine of not less than $200 nor more than $1,000; a state mandated $35 domestic violence fee and participation in weekly counseling sessions of no less than one and a half hours per week for not less than 6 months nor more than 12 months at my own expense. ND 2 . Offense in seven years: At least 10 days in jail but not more than 6 months, at least 100 hours but not more than 200 hours of community service, a fine of not less than $500 no more than $1000; a state mandated $35 domestic violence fee and participation in weekly counseling sessions of not less than one and a half hours per week for 12 months at my own expense. RD 3 . Offense in seven years: A category C felony punishable by a sentence of imprisonment in the Nevada State Prison for not less than 1 year no more than 5 years and a possible fine of not more than $10,000. ______ I understand I have the right to have an attorney represent me, and if I cannot afford an attorney the Court will appoint one, and I give up this right or I am represented by ____________________________. ______ I understand I have the right to a speedy trial and I give up this right. ______ I understand I have the right to confront and question all witnesses against me and I give up this right. ______ I understand that I have the right to subpoena witnesses on my behalf and compel their attendance and I give up this right. ______ I understand I have the right to remain silent and not incriminate myself, and I give up this right. ______ I understand that the punishments mentioned above are mandatory and the Judge is not bound by any agreement between the parties. ______ I am voluntarily pleading guilty/nolo contendere to the offense as stated in the first paragraph, without any promises of lenience or threats having been made. ________________________________ ______ ___________________ __________ ___________ Defendants Signature Initials Social Security Number Date of Birth Todays Date I am the attorney of record for Defendant. I have fully discussed the matters herein with Defendant and advised Defendant thereon. The representations above are Defendants own. The plea and waivers were intelligently, voluntarily and expressly made. I join in the plea and waiver. I stipulate there is a factual basis for the plea. ________________________________________________________ ____________________ Attorney Date I have addressed Defendant personally, canvassed Defendant on the above to include the elements of this offense as supported by the facts, the possible penalties and Defendants Constitutional rights. I find the plea of guilty/nolo contendere is made voluntarily and with an understanding of the nature of the charge and consequences of the plea and order the plea be entered into the minutes of the court. _______________________________________________________ ___________________ Justice of the Peace Date