A-2 VIRGINIA: IN THE CIRCUIT COURT OF LOUDOUN COUNTY COMMONWEALTH OF VIRGINIA ) ) v. ) ) ____________________________________) Defendant CRIMINAL NO. _________ WAIVER OF RIGHT TO INDICTMENT TO: The Judge of the Circuit Court of Loudoun County, Virginia: I, _______________________, in the presence of the Honorable Judge of the Circuit Court of Loudoun County, Virginia, and with the consent and approval of ______________________, Attorney for the Commonwealth for said County, and ______________________, my counsel, this _______ day of _________, 200_, hereby waive indictment by the grand jury, and consent to be tried on the warrant, as provided for under Section 19.2-2l7 of the Code of Virginia, 1950, as amended. Given under my hand this ______day of _______________, 200_. __________________________ DEFENDANT SEEN & APPROVED: ______________________________ JUDGE ______________________________ ATTORNEY FOR THE COMMONWEALTH ______________________________ COUNSEL FOR DEFENDANT American LegalNet, Inc. www.USCourtForms.com