Petition For Entry Of A Guilty/nolo Contendere Plea Form - The Court Of Common Pleas Of Northumberland County, Pa Page 2
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2
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4COMMONWEALTH OF PENNSYLVANIA
:
IN THE COURT OF COMMON PLEAS
:
OF NORTHUMBERLAND COUNTY, PA
v.
:
:
CRIMINAL LAW DIVISION
________________________________________, :
NO. CR__________________
PETITION FOR ENTRY OF A GUILTY / NOLO CONTENDERE PLEA
(Use a separate face sheet for each CR#)
Max.
CR #
Count #
Charge
Section
Grade
Fine
Years
Plea
Restitution
Mandatory Sentencing Requirements:
______________________________________________________
__________________________________________________________________________________________
Terms of Plea Agreement:
__________________________________________________________________
__________________________________________________________________________________________
Deadly Weapons Enhancement?
______________
School Zone Enhancement? _________________
License Suspension? __________________________
Has defendant watched video? ________________
Offense Gravity Score:
____________________
Prior Record Score:
________________________
Defense Attorney:
__________________________
Assistant District Attorney: ___________________
--------------------------------------------------------------------------------------------------------------------------------------
GUILTY PLEA / NOLO CONTENDERE PLEA
You are present before this Court because of your wish to plead guilty or nolo contendere to some or all of the
criminal charges pending against you. Please answer all of the following questions.
This is a sworn statement. After you have finished reading and filling out this form, you should sign it on pages
#2 and #4, on the line that reads "Defendant". You should also initial the bottom of page #3, but only after you have read
and understood each page. If there is anything you do not understand on this form, you should tell your lawyer or the
judge so that they can explain it to you fully, to make certain you understand all of your rights.
I understand and agree that I am pleading guilty or nolo contendere to the crimes listed above. I understand the
maximum penalties are set forth above and the mandatory minimum sentences and enhancements. I understand and agree
with the terms of the plea agreement.
Defendant's Signature:_________________________________
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