FORM 28A [Section 172C]

APPLICATION FOR PLEA BARGAINING

To the High Court Judge/Sessions Court Judge/Magistrate,
Whereas a Charge/Charges in respect of an offence/offences has/have been
preferred against me/us by the Public Prosecutor as follows:

(A brief description of the offence/offences) Please attach a copy of the

Charge/Charges

I (state the full name and the Identity Card no.), hereby apply to this Court for
the said Charge/Charges to be set down for hearing for Plea Bargaining (state
whether in respect of the sentence or the charge) and the Public Prosecutor to be
informed of this application.
I solemnly declare that this application is voluntarily made after understanding
the nature and extent of the punishment provided under the law for the offence/
offences that I am charged with.

Dated this……………….day of ………………………20………

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Signature of the Accused Person

Application received by ……………………………………..

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