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Statement of Defendant on Plea of Guilty Page 1 of 4 Revised April 2014 IN THE MUNICIPAL COURT OF EVERETT SNOHOMISH COUNTY, WASHINGTON CITY OF EVERETT, NO. Plaintiff, STATEMENT OF DEFENDANT ON PLEA OF GUILTY vs. Defendant. 1. My true name is: 2. My age is: 3. I went through the grade. 4. I HAVE BEEN INFORMED AND FULLY UNDERSTAND THAT: I have the right to representation by a lawyer and that if I cannot afford to pay for a lawyer, one will be provided at no expense to me. I wish to waive my right to an attorney at this time My attorney is: I am charged with: but I am pleading guilty to Attempted The elements are: ¨ In the defendant committed the offense against another family or household member as defined in RCW 10.99.020. The maximum possible sentence is: 1 year jail/$5000 fine 90 days jail/$1000 fine Other There is is not a minimum sentence. The Court will impose costs as part of my sentence, which will be in addition to the fine. 5. I UNDERSTAND I HAVE THE FOLLOWING IMPORTANT RIGHTS, AND I GIVE THEM ALL UP BY PLEADING GUILTY: The right to a speedy and public trial by an impartial jury in the county where the crime is alleged to have been committed; The right to remain silent before and during trial, and the right to refuse to testify against myself; The right at trial to hear and question the witnesses who testify against me; The right at trial to testify and to have witnesses testify for me. These witnesses can be made to appear at no expense to me; I am presumed innocent unless the charge is proven beyond a reasonable doubt or I enter a plea of guilty; The right to appeal a finding of guilt after a trial. 6. IN CONSIDERING THE CONSEQUENCES OF MY GUILTY PLEA, I UNDERSTAND THAT: ---PAGE BREAK--- Statement of Defendant on Plea of Guilty Page 2 of 4 Revised April 2014 The prosecuting attorney will make the following recommendation to the judge: Alc/Drug Eval & comply Mental Health Evaluation DV Treatment DV Victim Panel No Vic Contact Possess no Firearms Forfeit Weapon Anger Mgmt Theft Awareness Class DVS Victim as Df Course SOAP/SODA Order Do Not Return Exclusion Order DUI Victim Panel Ignition Interlock No BAC refusal No driving w/ .02 or > No driving w/o lic & ins No major moving violations Reserve Restitution Served Consecutive to: Served Concurrent with: Credit/Time Served No animal control violations No further similar violations No further criminal law violations Other: The judge does not have to follow anyone’s recommendation as to sentence. The judge can give me any sentence up to the maximum authorized by law no matter what the prosecuting authority or anyone else recommends The judge may place me on probation for up to five years if I am sentenced for a domestic violence offense or under RCW 46.61.5055, or up to two years for all other offenses and impose conditions of probation. If the court orders me to appear at a hearing regarding my compliance with probation and I fail to attend the hearing, the term of probation will be tolled until I appear before the court on the record. The judge may require me to pay costs, fees and assessments authorized by law. The judge may also order me to make restitution to any victims who lost money or property as a result of crimes I committed. The maximum amount of restitution is double the amount of the loss of all victims or double the amount of my gain. If I am not a citizen of the United States, a plea of guilty to an offense punishable as a crime under state law is grounds for deportation, exclusion from admission to the United States, or denial of naturalization pursuant to the laws of the United States. NOTIFICATION RELATING TO SPECIFIC CRIMES: The crime of has a mandatory minimum sentence of days in jail and fine, plus costs and assessments. The law does not allow any reduction of this sentence. If this case involved driving while under the influence of alcohol and/or being in physical control of a vehicle while under the influence of alcohol and/or drugs, I have been informed and understand that I will be subject to the penalties in the “DUI” Attachment If I am convicted of a crime of violence, any crime of domestic violence or any crime of harassment I may not possess, own, or have under my control any firearm unless my right to do so is restored by a superior court in Washington State, and by a federal court if required and that I must immediately surrender any concealed pistol license. RCW 9.41.040. If this is a crime of domestic violence, I may be ordered to pay a domestic violence assessment of up to $100.00 This plea of guilty will result in suspension or revocation of my driving license or privilege by the Department of Licensing for a period of This period may not include suspension or revocation based on other matters. If this crime involves a drug offense, my eligibility for state and federal education benefits will be affected. 20 U.S.C. § 109 I understand that if I am pleading guilty to a crime involving prostitution, the City will ask the judge to enter a “Stay Out of Areas of Prostitution” order prohibiting me from being in certain areas of the city. I have reviewed and understand the proposed order. I understand that if I am pleading guilty to a crime involving a controlled substance or drug paraphernalia, the City might ask the judge to enter a “Stay Out of Drug Areas” order prohibiting me from being in certain areas of the city. I have reviewed and understand the proposed order. ---PAGE BREAK--- Statement of Defendant on Plea of Guilty Page 3 of 4 Revised April 2014 Travel Restrictions: I will be required to contact my probation officer to request permission to travel or transfer to another state if I am placed on probation for one year or more and this crime involves: an offense in which a person has incurred direct or threatened physical or harm; (ii) an offense that involves the use or possession of a firearm; (iii) a second or subsequent misdemeanor offense of driving while impaired by drugs or alcohol; (iv) or a sexual offense that requires the offender to register as a sex offender in the sending state. I understand that I will be required to pay an application fee with my travel or transfer request. 7. I plead guilty to: count count count as charged in the complaint(s) or citation(s) and notice, or as amended. I have received a copy of that complaint or citation and notice. 8. I make this plea freely and voluntarily. 9. No one has threatened harm of any kind to me or to any other person to cause me to make this plea. 10. No person has made promises of any kind to cause me to enter this plea except as set forth in this statement. 11. Statement of Facts: The judge has asked me to state in my own words what I did that makes me guilty of the crime(s). This is my statement (state the specific facts that support each element of the crime(s)): [ ] I committed this crime against a family or household member as defined in RCW 10.99.020. [ ] Instead of making a statement, I agree that the court may review the police reports and/or a statement of probable cause supplied by the prosecution to establish a factual basis for the plea. ---PAGE BREAK--- Statement of Defendant on Plea of Guilty Page 4 of 4 Revised April 2014 12. My lawyer has explained to me, and we have fully discussed, all of the above paragraphs. I understand them all. I have been given a copy of this “Statement of Defendant on Plea of Guilty.” I have no further questions to ask the judge. Defendant I have read and discussed this statement with the defendant and believe that the defendant is competent and fully understands the statement. Prosecuting Attorney WSBA No. Defendant's Lawyer WSBA No. Print Name Print Name The foregoing statement was signed by the defendant in open court in the presence of the defendant's lawyer and the undersigned judge. The defendant asserted that [check appropriate box]: The defendant had previously read the entire statement above and that the defendant understood it in full; The defendant's lawyer had previously read to him or her the entire statement above and that the defendant understood it in full; or An interpreter had previously read to the defendant the entire statement above and that the defendant understood it in full. The Interpreter’s Declaration is attached. I find the defendant's plea of guilty to be knowingly, intelligently and voluntarily made. Defendant understands the charges and the consequences of the plea. There is a factual basis for the plea. The defendant is guilty as charged. Dated: Judge o Interpreter’s Declaration Attached