Acknowledgment And Waiver Of Rights Page 2
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4Acknowledgment and Waiver of Rights
III. Title of Offense Charged/Statutory Citation: _____________________________________________________
Elements of the Offense Charged: _______________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
*Please provide the above requested information on a separate attachment if the defendant is pleading to more than
3 offenses.
2. Penalties.
The defendant also acknowledges, understands and agrees that the maximum penalties for the offense(s)
are:
A.
A maximum prison term of ___ years and a mandatory minimum sentence of ___ years;
B.
A maximum fine of $
(18 U.S.C. §3571) and an additional fine to pay the costs of
any imprisonment, probation or supervised release ordered (U.S.S.G. § 5E1.1(I));
C.
A mandatory special assessment of $100.00 [for each count of conviction] which the defendant
agrees to pay at or before the time of sentencing; and
D.
A term of supervised release of not more than ___ years. The defendant understands that the
defendant’s failure to comply with any of the conditions of supervised release may result in revocation
of supervised release, requiring the defendant to serve in prison all or part of the term of supervised
release, with no credit for time already spent on supervised release (18 U.S.C. §3583).
E.
The defendant also acknowledges, understands and agrees that, in addition to the other penalties
provided by law, the Court may order the defendant to pay restitution to the victim of the offense,
pursuant to 18 U.S.C. §3663.
3. Waiver of Trial Rights and Consequences of Plea.
The defendant acknowledges, understands and agrees that he/she has the right to be represented by an
attorney at every stage of the proceeding and, if necessary, one will be appointed to represent the defendant.
The defendant also acknowledges, understands and agrees that he/she has the right:
A.
to plead not guilty or to maintain that plea if it has already been made;
B.
to be tried by a jury and, at that trial, the right to the assistance of counsel;
to confront and cross-examine witnesses against him/her;
C.
D.
not to be compelled to provide testimony that may incriminate the defendant; and
E.
the right to compulsory process for the attendance of witnesses to testify in the defendant’s defense.
The defendant acknowledges, understands and agrees that by pleading guilty he/she waives and gives up
those rights and that if a plea of guilty is accepted by the Court, there will not be a further trial of any kind.
The defendant acknowledges, understands and agrees that if he/she pleads guilty, the Court may ask him/her
questions about the offense, and if the defendant answers those questions falsely under oath, on the record, and in
the presence of counsel, the defendant’s answers may later be used against the defendant in a prosecution for perjury
or making false statements.
Page 2
USDCNH-88 (1-16)
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