_____________ Court ____________ County ____________ Tennessee INITIAL APPEARANCE Case Number page 1 of 2 _____________________________________________ vs. _______________________________________________ NOTICE OF RIGHTS: This is to certify that the defendant first appeared in this Court on this date and, pursuant to Tenn. R. Crim. P. 5, was advised of the following facts and rights: (1) the charge and the contents of the affidavit of complaint; (2) to be prosecuted only upon an indictment or presentment; (3) to be tried by a jury; (4) to a preliminary examination; (5) to counsel and to appointed counsel if indigent; (6) to remain silent and give no statement; (7) any statement given voluntarily may be used against the defendant; and (8) the general circumstances in which the defendant may obtain pretrial release. Upon motion of the defendant, and good cause having been shown, defendant’s bond is hereby set at the sum of $_____________ and/or the same is conditioned upon:________________________________________. __________________________ Judge/Judicial Commissioner ________________ Date PLEA AND WAIVER OF RIGHTS: Having been fully advised of my rights, I plead NOT GUILTY. I plead GUILTY to violation of T.C.A.__________________________________. I have been advised by the Court of the following: (1) the nature of the charge(s) to which the plea is offered; (2) the mandatory minimum penalty provided by law, if any, and the maximum possible penalty provided by law; (3) if applicable, a different or additional punishment may result by reason of my prior conviction(s) or other factors which may be established in the present action after the entry of my plea; (4) if applicable, any prior convictions may be presented to the Court for its consideration in determining punishment; and (5) that I have the following rights: (a) to be prosecuted only upon an indictment or presentment; (b) to be represented by an attorney at every stage of the proceeding and, if necessary, to the appointment of an attorney; (c) to plead not guilty or to persist in that plea if it has already been made; (d) to be tried by a jury and to the assistance of an attorney at such a trial; (e) to confront and crossexamine witnesses against me; (f) not to be compelled to incriminate myself; (g) to have an appellate court review the basis of my conviction; and (h) to have a jury set any fine greater than $50.00. I understand that if I plead guilty I waive all of these rights, including my right to a trial. I understand that there will not be a trial of any kind. Pursuant to the terms of my plea agreement, there will will not be a sentencing hearing. I understand that if I plead guilty I may be asked questions about the offense(s) to which I have pleaded, and if I answer these questions under oath, on the record, and in the presence of counsel, my answers may later be used against me in a prosecution for perjury or aggravated perjury. After carefully considering all of these matters, I voluntarily waive my rights and request that the Court accept my plea of GUILTY. _____________________ Attorney for Defendant ___________ Date _______________________ Defendant I addressed the defendant personally in open court, advised him/her of the rights itemized above, inquired into his/her understanding of the consequences of entering a guilty plea, and inquired into the accuracy of the plea. I hereby conclude that the defendant understands his/her rights, that the plea is voluntary and not the result of force or threats or of promises apart from a plea agreement, that there is a factual basis for the plea, and that the defendant’s willingness to plead guilty results from prior discussions between the District Attorney General and the defendant or the defendant’s attorney. I find that the plea of GUILTY heretofore entered by the defendant is acceptable and, therefore, accept the plea. The judgment and sentence shall reflect the disposition provided for in the plea agreement. _____________________ Judge ___________ Date PRELIMINARY HEARING WAIVER OF RIGHTS: Being fully advised of his/her rights, the Defendant hereby waives: 10/30 days; The right to a preliminary hearing within The right to a preliminary hearing. The right to counsel at the preliminary hearing; Tenn. R. Crim. P. 44 requires defendants to execute a written waiver of the right to counsel. However, the Court must also orally explain many rights, and the effect of a waiver of those rights, prior to accepting the defendant’s waiver. See Tenn. R. Crim. P. 44(a); Smith v. State, 987 S.W.2d 871 (Tenn. Crim. App. 1998). Date: Defendant: Defendant’s Attorney: Judge: ORDER: Date: BOUND OVER to the Grand Jury of said County The Court having found probable cause that an offense occurred and that Defendant committed the offense herein. Defendant having waived the right to a preliminary hearing. DISMISSED with cost taxed to the State, the Court finding that the State has failed to show probable cause in this matter. Defendant is hereby ordered to appear in the General Sessions/Criminal Court for this County on . . Bond is hereby set at $ Judge: American LegalNet, Inc. www.USCourtForms.com _____________ Court ____________ County ____________ Tennessee INITIAL APPEARANCE Case Number page 2 of 2 _____________________________________________ vs. _______________________________________________ FAILURE TO APPEAR Defendant having failed to appear as ordered, issuance of an Attachment, Arrest Warrant, or Capias is hereby ordered. Bond is set at . Conditional forfeiture of bond ordered. $ Upon motion of , Surety for the Defendant in this cause, and notice to the Defendant; and for good cause shown to the Court, the Defendant s bond is hereby revoked and the Defendant shall be arrested and held in the County jail until substitute bond has been secured or Defendant is released as otherwise by Order of this Court. Final forfeiture of bond taken on notice to sureties. Date: Judge:_________________________________________________ JUDGMENT Upon TRIAL/PLEA, the court finds Defendant GUILTY/NOT GUILTY of the offense charged or Retired for a period of Dismissed, on motion of Costs taxed to: Cash bond forfeited to payment of fine and costs Separate orders attached SENTENCE Fined $ and cost; and/or Sentenced to serve months and days in the County jail, beginning . at AM/PM. Sentence is suspended except for months and days; and/or Defendant s driving privilege is suspended for: ; and/or Defendant is placed on probation through for a period of and the Defendant s probation/suspended sentence is conditioned upon: and paying fines/cost/restitution and complying with all laws. Other: If Defendant is in violation of Defendant s suspended sentence/probation, Defendant shall serve as a offender. Date: % of the sentence herein Judge: POST JUDGMENT ORDERS The Court hereby finds that the Defendant has violated the condition/s of Defendant s probation/suspended sentence, by reason of and is hereby ordered to serve months and days in the County jail. The Court hereby finds that the Defendant is in contempt of Court for having failed to pay fines and cost as heretofore ordered and Defendant shall serve out the balance thereof, according to law, at the rate of $5.00 per day in the County jail, for a total of days. Defendant may post a cash bond of $ . Date: Judge: American LegalNet, Inc. www.USCourtForms.com