IN THE MUNICIPAL COURT OF DELAWARE COUNTY, OHIO CRIMINAL/TRAFFIC DIVISION , Plaintiff, -vs- Case No. Judge David P. Sunderman , Defendant. AGREED JUDGMENT ENTRY SUPPLEMENTAL ARRAIGNMENT Upon the agreement of the parties and for good cause shown, the Court has determined that this case involves exceptional circumstances and that, in the interest of judicial economy and efficiency, the same should be disposed of by supplemental arraignment pursuant to D.M.C. Emergency Rule 8.00(o). DEFENDANT’S CERTIFICATION. By his or her signature below, the Defendant acknowledges and certifies that he or she: 1. consents to the Magistrate ruling on this entry if this case is a traffic case; 2. has been informed by counsel of: A. B. the effects of the pleas of guilty, no contest, and not guilty; C. the possibility of deportation for persons who are not citizens of the United States; D. the right to appeal; E. any affirmative defense which may have been available; F. 3. the penalties for all offenses with which he or she is charged; and that he or she has had sufficient time to ask any questions of counsel that may have arisen about this pleading and that counsel has answered those questions to his or her satisfaction; knowingly, intelligently, and voluntarily waives: A. the right to appear in court and to appear in court with counsel; APPENDIX A Revised January 27, 2004 American LegalNet, Inc. www.USCourtForms.com B. the right to a trial and the right to jury trial, if applicable; C. the right to require the prosecution to prove his or her guilt beyond a reasonable doubt at trial; D. the right to confront and cross-examine witnesses at trial; E. the right to compulsory process; F. the privilege against self-incrimination; G. any objection to the use of the supplemental arraignment procedure, acknowledges receiving a benefit from the use of this procedure, and requested the use of this procedure; H. the right to present any evidence regarding any affirmative defenses which may have been available; 4. stipulates that the facts contained on the complaints warrant a finding of guilty by the court; 5. acknowledges that he or she has read all of the information in this pleading, all of the information contained in this pleading constitutes the sum and substance of the plea negotiations between the prosecution and the defense, agrees with those negotiations, and requests the court to follow those negotiations; 6. pleads GUILTY to all of the following offenses: A. B. ; C. ; D. 7. ; ; voluntarily remits payment for all fines and costs for offenses in this case. DEFENSE COUNSEL’S CERTIFICATION. By his or her signature below, defense counsel acknowledges or certifies that he or she has read all of the information in this pleading and that he or she: 1. has caused the defendant to be informed of all of the information contained in this pleading; 2. has invited this procedure by filing the appropriate motion with the court, has advised the defendant to execute this pleading, believes that this pleading is in the best interest of the defendant, and has no objection to the use of this procedure; 3. has caused this pleading to be prepared and transmitted to the court in its current form; and that it is in compliance with this court’s guidelines regulating supplemental arraignments; Revised January 27, 2004 American LegalNet, Inc. www.USCourtForms.com 4. is in agreement with items 1 through 6 certified or acknowledged by the defendant. PROSECUTOR’S CERTIFICATION. By his or her signature below, the prosecutor acknowledges or certifies that he or she has read all of the information in this pleading and that he or she: 1. has no objection to the use of the procedure; 2. has reviewed the substance of sentence in this case and finds that it fully comports with the negotiations of the parties and the guidelines of this court regulating supplemental arraignments. Defense Counsel Date Prosecutor Date The undersigned, being duly sworn, states under oath that he or she is the named defendant in the abovecaptioned case, that he or she has read the foregoing document in its entirety, and that he or she is signing this document knowingly, voluntarily, and intelligently and that the information provided by him or her is true and accurate. Defendant Street address and P. O. Box or Apt. # DOB City, State, Zip Code SSN Telephone Number Sworn and subscribed in my presence this day of ,2 . Notary Public Revised January 27, 2004 American LegalNet, Inc. www.USCourtForms.com DELAWARE MUNICIPAL COURT, DELAWARE, OHIO State of Ohio City/Village/Twp. of Plaintiff -vsDefendant Case No. ¶ ¶ # OVI Violations within 6 Years DOB SSN Arrest/Offense Date Wherefore it is, ORDERED, ADJUDGED, and DECREED as follows: of The Court hereby accepts defendant’s guilty plea and enters a finding of guilty as to the following charge . JAIL: Days Imposed: Days Credited: Days Suspended: G Conditions: G EMHA Days: G CWP Required Hours: G Work Release: Days: Hours: Enforcement Date: G Alcohol Treatment: Effective: G No room at the County Jail for 60 days. LICENSE SUSPENSION: Court Suspension: Days/Years: Effective: G Proof of Financial Responsibility (FR) is attached. (Failure to attach proof of insurance at the time of offense shall result in notification to BMV of failure to show FR and revocation of plates and registration pursuant to R.C. 4509.101.) G Revoke Plates and Registration pursuant to 4507.164 and/or 4509.101 G Family Plates G Occupational Privileges Granted Effective: G Interlock Required As follows: FINES AND COSTS: Fine: Imposed $ G CWP in Lieu of Fines Suspended $ Credited $ G Court Costs $ Revised January 27, 2004 American LegalNet, Inc. www.USCourtForms.com PROBATION: Term of Probation months/years G Reporting G Non-Reporting G Report to the Probation Division within five business days of the filing of this entry G Standard terms as prescribed by separate entry through the Probation Department G EMHA standard terms as prescribed by separate entry through the Probation Department G Specific terms: The companion charge(s) as contained in Case Number(s) hereby dismissed. is/are The companion charge(s) as contained in Case Number(s) hereby dismissed subject to payment of local costs. is/are Date: Judge / Magistrate cc: Prosecution Defense Counsel Probation Division Revised January 27, 2004 American LegalNet, Inc. www.USCourtForms.com