Consent to Videoconferencing from Magistrate and Municipal Courts to Detention Facilities Name of Defendant Type of Proceeding: Bond Hearing Preliminary Hearing Guilty Plea and Sentencing Trial Court: Criminal Charging Document No. MAGISTRATE COURT OF _______________ MUNICIPAL COURT OF _________________ By my signature below, I, the defendant, consent to the use of videoconference equipment in this criminal proceeding. The court will maintain the audiotape of this proceeding for a period of sixty (60) days from today's date in all proceedings, except preliminary hearings, which must be maintained for three (3) years, after which the audiotape may be destroyed. I hereby waive territorial jurisdiction. I have been fully informed of my right to be personally present before the court for this criminal proceeding and, with that knowledge, I voluntarily waive that right. I have been fully informed that by participating in this hearing before the magistrate or municipal judge by means of videoconferencing, I understand and acknowledge that I am voluntarily appearing before the magistrate or municipal judge and submitting myself to the court's jurisdiction. Attorney for Defendant (where applicable) Signature of Defendant Date Defendant's Waiver of Right to Counsel � Check if Applicable I hereby acknowledge that I have been fully informed of my right to counsel and, with that knowledge, I voluntarily waive that right. Signature of Defendant SCCA/651 (08/2008) American LegalNet, Inc. www.FormsWorkFlow.com