VIRGINIA: IN THE CIRCUIT COURT OF THE COUNTY OF PRINCE WILLIAM COMMONWEALTH OF VIRGINIA VS. CRIMINAL NUMBER(S) Defendant WAIVER OF JURY I, the undersigned Defendant, having been advised of my right to have a trial by jury waive my right to a trial by jury, and request the Court to hear all matters of law and fact in the above case(s). Dated this day of , . Defendant Attorney for the Defendant In concur in the above. Dated this day of , . Attorney for the Commonwealth The Court, being of the opinion that the foregoing waiver is voluntarily and understandingly made by the defendant, doth accept and concur in the said waiver, and it is hereby ORDERED that the consent of the defendant and concurrence of the Commonwealth222s Attorney and of the Court are here entered of record. Filed and made a part of the record this day of , . JUDGE American LegalNet, Inc. www.FormsWorkFlow.com