Defendant(s) : ...................................................... THE PEOPLE OF THE STATE OF NEW YORK Case Name: TO Cause No.: Attachment A: Paragraph 6(k), driving under the influence of alcohol and/or actual physical control of a vehicle while under the influence of alcohol and/or drugs. (If required, attach to Statement of Defendant on Plea of Guilty.) Department of Licensing - DUI Administrative Sanctions and Reinstatement Provisions (as amended through June 1, 2001) GREETINGS: ADMINISTRATIVE SANCTIONS – RCW 46.20.3101 (Effective January 1, 1999) Second or Subsequent Refusal Within Past 7 Years OR First Refusal And At First Refusal Within COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before WE 7 Years And No Prior Least One Prior Administrative Action Within Past 7 Years (Revocation REFUSED TEST Administrative Action Within Past 7 Years , the Honorable at the Court consecutive to any court ordered suspension as a result of same incident) Adult 1-Year License Revocation 2-Year located at License Revocation County of Minor 1-Year License Revocation , on the in room day of 2-Year License Revocation Or Until Age 21 Whichever Is Longerat any recessed , 20 , at o'clock in the noon, and ALCOHOL or adjourned date, to testify and give evidence as a witness in this action on the part of the CONCENTRATION First Administrative Action Second or Subsequent Administrative Action TEST RESULT Adults With 0.08 or 90-Day License Suspension 2-Year License Revocation Greater Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Minors With 0.02 or 90-Day License Suspension behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a 1-Year License Revocation Or Until Age 21 Whichever Is Longer the party on whose Greater result of your failure to comply. Note: An individual convicted of DUI or physical control will have his/her driving privilege placed in probationary status for five years from the date he/she is eligible to reinstate his/her driver’s license. (See RCW 46.61.5055 and 46.20.355) An individual granted a deferred prosecution under RCW Witness, Honorable , one of the Justices of the 10.05.060 will have his/her driving privilege placed on probationary status for five years from the date of the incident, which was the basis for the County, day of , 20 RCW 46.20.355 and 10.05.060) deferred prosecution. (See Court in REQUIREMENTS FOR REINSTATEMENT OF DRIVING PRIVILEGE Suspended License* (RCW 46.20.311) Revoked License* (RCW 46.20.311) • File and maintain proof of financial responsibility for the future with the • File and maintain proof of financial responsibility fornamefuture with the (Attorney must sign above and type the below) Department of Licensing as provided in chapter 46.29 RCW Department of Licensing as provided in chapter 46.29 RCW • Pay $150 driver’s license reissue fee (Effective June 11, 1998) • Pay $150 driver’s license reissue fee (Effective June 11, 1998) • Driver’s ability test NOT required • Satisfactorily complete a driver’s ability test * If suspension or revocation is the result of a criminal conviction, the driver must also show proof of eitherAttorney(s) for satisfactory participation in an (1) enrollment and approved alcohol treatment program or (2) completion of an alcohol information school, as determined by the court and/or treatment agency. COURT DUI SENTENCING GRID (RCW 46.61.5055 as amended through June 1, 2001) “Prior Offense” includes the following: (as defined in RCW 46.61.5055) Original Convictions for the following: (1) DUI (RCW 46.61.502) (or an equivalent local ordinance); (2) Phys. Cont. (RCW 46.61.504) (or an equivalent local ordinance); (3) Veh. Homicide (RCW Office and P.O. Address 46.61.520) or Veh. Assault (RCW 46.61.522) if either committed while under the influence; (4) Equiv. out-of-state statute for any of the above offenses. Attachment “A” (continued) STATEMENT OF DEFENDANT ON PLEA OF GUILTY (Attachment “A”) – Page 1 of 2 CrRLJ 04.0200 (4/2002) – CrRLJ 4.2(g) Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com Defendant(s) : ...................................................... THE PEOPLE OF THE STATE OF NEW YORK Amended Convictions for the following: If the person was originally charged with DUI or Phys. Cont. or an equivalent local ordinance, or Veh. Homicide (RCW 46.61.520) or Veh. Assault (RCW TO 46.61.522). (1) Neg. Driving 1st (RCW 46.61.5249); (2) Reckless Driving (RCW 46.61.500); (3) Reckless Endangerment (RCW 9A.36.050); (4) Equiv. out-of-state or local ordinance for the above offenses. Deferred Prosecution Granted for the following: (1) DUI (RCW 46.61.502) (or equivalent local ordinance); (2) Phys. Cont. (RCW 46.61.504) (or equivalent local ordinance); (3) Neg. Driving 1st (RCW 46.61.5249), (or equiv. local ord.), if the person was originally charged with DUI or Phys. Cont. (or an equiv. local ord.), or Veh. Homicide (RCW 46.61.520) or Veh. Assault (RCW 46.61.522). “Within seven years” means that the arrest for a prior offense(s) occurred within 7 years of the arrest for the current offense. (As defined in RCW 46.61.5055.) GREETINGS: No Prior Offenses Within Past One Prior Offense Within Past Two or More Prior Offenses Within 7 Years 7 Years Past 7 Years WE COMMAND YOU, 30-365 Days (30 days non-suspendable) 90-365 Days (90 days you 1-365 Days (24 consecutive hours that all business and excuses being laid aside, you and each ofnon- attend before , the Honorable at the Courtsuspendable) non-suspendable) County of Mandatory Minimum located at Electronic Home Monitoring* In Lieu of 60 Days 120 Days inJail Time, Not Less on the Daysday of room , Than 15 , 20 , at o'clock in the noon, and at any recessed or$350-$5,000date, to testify and give$500-$5,000 ($975 total minimum fine on $1,000-$5,000 ($1,775 total minimum adjourned ($735 total minimum evidence as a witness in this action the part of the Fine fine w/statutory assessments****) w/statutory assessments****) fine w/statutory assessments****) Driver's License 90-Day Suspension 2-Year Revocation 3-Year Revocation Ignition Interlock Device Court may order** Not Less Than 1 Year** Not Less Than 1 Year** Your By The Court Alcohol/Drug Ed. or Treatment As Determinedfailure to comply with this subpoena isThe Court as a contempt of court and will Court you liable to As Determined By punishable As Determined By The make the No Prior Offensesbehalf this subpoenaOne Prior Offense Within Past penaltyTwo$50More all damages sustained as a party on whose Within Past was issued for a maximum of or and Prior Offenses Within Alcohol Concentration At Least 7 Years 7 Years Past 7 Years .15 or Greater Or Test Refusal result of your failure to comply. Jail Time*** 2-365 Days (2 consecutive days 45-365 Days (45 days non-suspendable) 120-365 Days (120 days nonnon-suspendable) Honorable suspendable) Justices of the Witness, , one of the Electronic Home Monitoring* In Lieu of Mandatory Minimum 90 Days 150 Days CourtTime, Not Less Than 30 Days in County, day of , 20 Jail Fine $500-$5,000 ($975 total minimum $750-$5,000 ($1,375 total minimum fine $1,500-$5,000 ($2,575 total minimum fine w/statutory assessments****) w/statutory assessments****) fine w/statutory assessments****) Driver's License 1-Year Revocation 900-Day Revocation (Attorney must4-Year Revocationname below) sign above and type Ignition Interlock Device Not Less Than 1 Year** Not Less Than 1 Year** Not Less Than 1 Year** Alcohol/Drug Ed. or Treatment As Determined By The Court As Determined By The Court As Determined By The Court Alcohol Concentration Less Than .15 Or No Test Result Jail Time*** * Electronic Home Monitoring: For first time offenders, the court may impose electronic home monitoring in lieu of the mandatory minimum jail time. Courts may waive electronic home monitoring in writing stating the reasons therefore and facts relied upon. If EHM is waived, the court is required to impose an alternative sentence for similar punitive consequences. (RCW Attorney(s) with 46.61.5055.) ** Ignition Interlock: For a person previously ordered to install ignition interlock under RCW 46.20.720(3)(a) not less than 5 years, for a person previously ordered to install ignition interlock under RCW 46.20.720(3)(b) not less than 10 years. For application in DUI Deferred Prosecution, see: RCW 10.05.140. *** Mandatory conditions of probation if any jail time is suspended: (Court’s jurisdiction extended to five years if it imposes less than one year in jail - RCW 46.61.5055) (i) The individual is not to drive a motor vehicle within this state without a valid license to drive and proof of financial responsibility for the future, (ii) the individual is not to drive a motor vehicle within this state while having an alcohol concentration of .08 or more within two hours after driving, (iii) the individual is not to refuse to submit to a test of his orandbreath or blood to determine alcohol concentration Office her P.O. Address upon request of a law enforcement officer who has reasonable grounds to believe the person was driving or was in actual physical control of a motor vehicle within this state while under the influence of intoxicating liquor. **** Local Government Criminal Justice Funding Penalty: Effective July 22, 2001, the court must impose an additional local government criminal justice funding penalty of $50. RCW 46.64.055. STATEMENT OF DEFENDANT ON PLEA OF GUILTY (Attachment “A”) – Page 2 of 2 CrRLJ 04.0200 (4/2002) – CrRLJ 4.2(g) Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com