JD-1737, 03/12 Plea Questionnaire/Waiver of Rights (Delinquency) 247247938.23, 938.243 and 938.30, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 I am the juvenile and I intend to plead to the delinquency charges as follows: Charge /Statute Plea Charge /Statute Plea Admit No Contest Admit No Contest Admit No Contest Admit No Contest See attached sheet for additional charges . I am years old. I am in/have completed the grade in school. I do do not understand the English language. I do do not understand the charge (s) to which I am pleading , including whether any charge is a felony . I am not am currently receiving treatment for a mental illness or disorder. have not have had any alcohol, medications, or drugs within the last 24 hours. Constitutional Rights I understand that by entering this plea, I give up the following constitutional rights: I give up my right to a court trial. I give up my right to remain silent and I understand that my silence could not be used against me at trial . I give up my right to testify and present evidence at trial. I give up my right to use subpoenas to require witnes ses to come to court and testify for me at trial. I give up my right to confront in court the people who testify against me and cross - examine them. I give up my right to make the State prove me delinquent beyond a reasonable doubt . I understand the rights that have been checked and give them up of my own free will. Understandings I understand that the delinquency charge(s) to which I am pleading has/have elements that the State would have to prove b eyond a reasonable doubt if I h ad a trial. These elements have been explained to me by my attorney or are as follows: See attached sheet I understand that if the judge accepts my plea, the judge will find me delinquent of the charge(s) to which I am pleading based upon the facts in the petition and/or as stated in court. I understand that the judge does not need to follow any plea agreement or recommendation. My attorney has explained the possible dispositions the judge could order. Understandings I understand that if one of the charges to which I am pleading is a felony, I will lose any right to possess a firearm or ammunition. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE INTEREST OF Name Plea Questionnaire/ Waiver of Rights (Delinquency) Case No. American LegalNet, Inc. www.FormsWorkFlow.com JD-1737, 03/12 Plea Questionnaire/Waiver of Rights (Delinquency) 247247938.23, 938.243 and 938.30, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 I understand that if I am found delinquent for an act that if committed by an adult would be a violent felony, it is unlawful for me to possess body armor. I understand that if I am found delinquent based on a serious child sex offense, I cannot engage in an occupation or participate in a volunteer position that requires me to work or interact primarily and directly with children under the age of 16. I understand that if any charges are read - in as part of a plea agreement they have the following effects: Disposition the judge may consider read - in charges in determining the disposition. Restit ution I may be required to pay restitution on any read - in charges. Future prosecution the State cannot prosecute me for any read - in charges. Voluntary Plea I have decided to enter this plea of my own free will. I have not been threatened or forced to enter this plea. No promises have been made to me other than those contained in the plea agreement. The plea agreement will be stated in court or is as follows : See attached Statement I have reviewed and understand this entire document and any attachments. I have reviewed it with my attorney , if any . I have answered all questions truthfully and either I or my attorney checked the boxes. I am asking the court to accept my plea and find me delinquent . Juvenile Date (If applicable) I am the attorney for the juvenile . I have discussed this document and any attachments with the juvenile . I believe the juvenile understands it and the plea agreement. The juvenile is making this plea knowingly, v oluntarily and intelligently. I saw the juvenile sign and date this document. Attorney Date American LegalNet, Inc. www.FormsWorkFlow.com