Application For Consent Of Court To Enter A Plea Page 3
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1
2
3I
U.S. C
,
:
F YOU ARE NOT A
ITIZEN
PLEASE READ AND SIGN
I
ACKNOWLEDGE THAT THE COURT HAS PERSONALLY ADDRESSED ME AND PROVIDED THE FOLLOWING
:
ADVISEMENT TO ME
“I
U
S
,
F YOU ARE NOT A CITIZEN OF THE
NITED
TATES
YOU ARE HEREBY ADVISED THAT CONVICTION OF
G
(
N
C
,
)
THE OFFENSE TO WHICH YOU ARE PLEADING
UILTY
OR
O
ONTEST
WHEN APPLICABLE
MAY HAVE
,
U
S
,
THE CONSEQUENCES OF DEPORTATION
EXCLUSION FROM ADMISSION TO THE
NITED
TATES
OR
.”
U
S
DENIAL OF NATURALIZATION PURSUANT TO THE LAWS OF THE
NITED
TATES
A
, I
I
.
DDITIONALLY
ACKNOWLEDGE THAT
UNDERSTAND THE ADVISEMENT
D
D
EFENDANT
ATE
I have personally addressed the defendant, provided the advisement set forth above to the
defendant, answered any questions the defendant may have had and, to the best of my ability,
determined that the defendant understood the advisement.
Magistrate/Mayor
Date
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