IN THE COUNTY COURT OF THE SIXTH JUDICIAL CIRCUIT

IN AND FOR PINELLAS COUNTY, FLORIDA

AALFWLE
STATE OF‘FLORIDA,
Caée Number(s): fl IA.
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PLEA FORM 5-11“ —‘
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l have appeared on the below—listed date in County Court,
criminal charge(s ) against me, and have entered a plea of
with a violation of probation, before the Judge.
Pineii
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No Contest, or ...34?», y,_
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By signing this plea form, l am swearing under oath before the Judge that I understand the followih‘g:

1. The nature of the charge(s) or nature of the violation if charged with a violation of probation.
2. The right to plead Not Guilty and the difference between the pleas of Not Guilty, Guilty, No Contest, and an Admission
if this is for a violation of probation, and the effect of each plea.

3. The right to a trial by jury, or if charged with a violation of probation, the right to a non-jury hearing before a judge;
P‘ The right to be represented by an attorney at every stage of the proceedings and the right to have an attorney
appointed ifl cannot afford one, unless the Judge has issued a written order of no incarceration.
The right to confront and cross-examine witnesses at trial or at a hearing on a violation of probation.
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The right to compel the attendance of witnesses on my behalf at trial or a hearing on a violation of probation.
The right not to testify or be compelled to incriminate myself.
The right to require the State to prove my guilt beyond a reasonable doubt, or if charged with a violation of probation,
the right to require the State to prove by the greater weight of the evidence that l have willfully violated my probation.
9. The maximum and minimum possible penalty for each charge, including any applicable minimum--mandatory term(s).
10. That the Judge may question me about the offense(s) and that any false answer may be used against me in a perjury
prosecution.
11. That if | am not a United States Citizen, this plea may have the additional consequence of changing my immigration
status, including deportation or removal from the United States. lfl need additional time to discuss this matter with
counsel, must request to
l do so at this time, and the Court must allow me a reasonable amount of time to confer with
counsel before accepting my plea.
12. That have ever been convicted of or pled Guilty or No Contest to a sexually violent or sexually motivated offense,
if l

or ifl am
required to register as a sexual offender, or ifl have ever been placed'In the custody of the Department of
Children and Families for evaluation as a sexually violent predator, may be subject to a civil commitment proceeding
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for sexually violent predators as a result of this plea.

13. That if am pleading Guilty or No Contest to an offense for which automatic, mandatory driver’s license suspension
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is
required by law to be imposed, this plea may result in the suspension or revocation of my driver's license.
14.‘ That by pleading Guilty or No Contest, l'
am hereby giving up my right to appeal all matters relating to the judgment,
including the issue of guilt or innocence, unless expressly reserved. If reserved, l have 30 days to appeal. retain my I

right to review by appropriate collateral attack.

15. That will be assessed all statutory fines and costs. agree to pay all fines and costs, including the fines and costs
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checked on the attached sheets, 'and hereby waive my right to individual announcement of these costs.
16. That if sentenced to probation, | will pay the cost of supervision as ordered by this Court commencing with the first
month of probation.

By pleading Guilty, No Contest, or by entering an Admission to a violation of probation, have sworn under oath before l

the Judge that | wish to give up the above— listed rights and, if no sentence has been agreed upon, have the Judge'Impose
the sentence the Judge deems appropriate.

Page 1 of 2 (County Plea Form)

COCR-88 Rev. Jan 2016

This plea is being freely and voluntarily made without promises or coercion. agree‘ that sufficient evidence exists which
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would allow a jury to determine my guilt or innocence in this matter. lf represented by counsel, am satisfied with that I

representation.

I am not presently suffe'ljing f_ro'm._any mental, emotional, or physical problems that adversely affect my understanding of
this plea and am
not under the influencé of any drugs, alcohol, or medicines that impair my ability to understand this plea.
l am able to read and write and. have read and understood every word of this plea form.

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Plea Terms tional.

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Credit for Time Served:

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I understand that pursuant to this negotiated plea agreement, will receive credit for time incarcerated before the
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imposition of the sentence as outlined in this section. also understand that am waiving any entitlement to jail credit in
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the above—styled case(s) other than what is explicitly agreed to below as part of this negotiated plea agreement.

Case Number(s)* Jail Credit

*lnclude all case numbers to which this plea applies.

If Not Represented bv'Counsel:

I have been advised that have a right to have a lawyer present with me during all stages of these proceedings, unless
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the Judge has issued a written order of no incarceration, and if necessary, my lawyer will be contacted and shall be l
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given an opportunity to confer with counsel before this cause proceeds further. hereby freely and voluntarily waive my |

right to be represented by a lawyer at this time and request thatl be allowed to represent myself.

Defendant
If Re resented b Counsel:
Ihave discussed the plea agreement with my client and believe my client understands the contents of the plea agreement
and'Is c mpetent to ente a to the charges.

Ufor
orne Defendant efendant

Sworn by the above- named Defendant before me on the _____day of

to ,

| hereby above- named Defendant appears alert and intelligent, understands the naturoe of the charge(s) and
find that the
the consequences of entering a plea of Guilty or No Contest or to a violation of probation, and the plea is
freely, knowingly, and voluntarily made.
afission

Presiding Judgev
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(Rev. 01/16)

Page 2 of 2

COCR-88 Rev. Jan 2016