STATE OF WASHINGTON COUNTY OF ISLAND CITY OF ) Plaintiff ) ) No. ) vs ) Waiver of Right to Lawyer (Arraignment) ) ) Defendant ) I am the defendant in this case. I understand that: 1.1 I am charged with the crime of: [a] [b] [c] 1.2 This crime has the following maximum penalty: [a] [b] [c] 1.3 I understand that I have the right to be represented by a lawyer including a public defender appointed at no expense to me if I am indigent, and that I have the right to have such a lawyer present at all hearings to defend me. 1.4 I understand that this Court will not continue further with this arraignment until a lawyer is here to help me if I request that a lawyer be here. 1.5 I further understand that waiving or giving up my right to a lawyer at this hearing does not prevent me from claiming a right to a lawyer in future proceedings in this case and have been so informed by this Court. WAIVER I voluntarily and with knowledge of the above rights give up my right to an attorney at arraignment. No promises or other inducements have been given or made to me to get me to give up this right. Dated and signed this day of , 20. Defendant American LegalNet, Inc. www.FormsWorkFlow.com