Rights, Instructions and Waiver Form

Please complete this form no sooner than 7 days prior to your scheduled court date. You will be emailed a copy of your answers to the email address you provide on this form.
I have hired a private counsel to represent me? *

Rights and Instructions


You may plead: a) not guilty; b) not guilty by reason of insanity; c) guilty with a mental illness at the time of the offense; d) guilty; or e) with the court's approval, no contest (a no-contest plea means you do not challenge the charge; it is still a conviction).



You have the right to be represented by an attorney. The court will appoint an attorney at no cost to you if: a) you cannot afford an attorney; and b) there is the possibility of a jail sentence for the offense. Later, you may have to pay for the appointed attorney's service if the court determines you are able to do so.

You have the right to represent yourself. If you do so, the court cannot advise you on how to handle your case, and you will be required to comply with technical legal rules. There may be disadvantages to proceeding without an attorney. For any future hearing, you must: a) represent yourself; b) hire an attorney; or c) if you cannot afford an attorney, request a court-appointed attorney by filing an affidavit at least 10 days before the proceeding. Failure to exercise option b or c will be treated as an implied waiver of your right to counsel.

You have the right to a speedy public trial before an impartial jury. If you want a jury trial, you must make a written demand at least 10 days prior to trial. You are not entitled to a jury trial if you are charged only with an infraction.

You have the right to confront and cross-examine the prosecution witness in open court.

You have the right to call witnesses and compel by subpoena their attendance and testimony. If you cannot afford to pay for the attendance of witnesses, the prosecution will pay those costs.

You have the right to testify on your behalf. Any statement you make may be used against you. You may refuse to testify, and no one can make you testify or give evidence against yourself. Your refusal to testify cannot be held against you.

You are presumed innocent until; a) you plead guilty or no contest; or b) the prosecution proves you guilty. The prosecution has the burden of proving each of the elements of the crime beyond a reasonable doubt. A jury verdict must be unanimous.

You have the right to bail. If you post bail, you will be released on; a) the condition you appear in court for future proceedings; and b) any other conditions the court imposes. Bail may be modified on proper motion, notice, and findings.


If you plead guilty or no contest, these rights are waived, and your plea constitutes an admission of all the elements of the crime.

IMMIGRATION / DEPORTATION: I understand that if I am not a United States citizen, my plea(s) today may, or even will, subject me to deportation under United States immigration laws and regulations, or otherwise adversely affect my immigration status, which may include permanently barring my re-entry into the United States. I understand that if I have questions about the effect of my plea(s) on my immigration status, I should consult with an immigration attorney.

GUN RESTRICTIONS: I understand that if I enter a guilty or no contest plea to certain offenses, or if I plead guilty and mentally ill to any offense, I will become a "restricted person" under state and/or federal law, giving up for at least some period my right to possess, purchase, transfer, or own firearms or ammunition, and requiring me to forfeit each firearm I currently possess. I acknowledge these restrictions will apply for offenses involving domestic violence (DV) or a controlled substance, and potentially other offenses as well. I acknowledge by signing below that my lawyer or the prosecuting attorney has informed me of these restrictions and the penalties I could face for a violation.

SENTENCING: Sentencing recommendations are not binding on the court. The court may order the sentence to run consecutively (one after the other) with the charges in this case and with any other case.

PENALTIES (MINIMUM / MAXIMUM SENTENCES): Class B Misdemeanor (0 days to 6 months jail, $0 to $1,000 fine plus surcharges, and interest); Class C Misdemeanor (0 days to 90 days jail, $0 to $750 fine plus surcharges, and interest); Infraction (no jail, $0 to $750 fine plus and surcharges, and interest).

OTHER CONSEQUENCES OF ENTERING A GUILTY OR NO CONTEST PLEA: I understand that there may be other collateral consequences such as but not limited to loss of voting privilege, loss of ability to run for elected office, and the loss of my driving privilege. I understand that I may ask the judge for more time to consult with an attorney. I do not wish to consult with an attorney. I still wish to proceed with the entry of my plea and ask the judge to accept my plea.

WITHDRAWAL OF PLEA / RIGHT TO APPEALI understand that if I want to withdraw my guilty (or no contest) plea(s),  I must file a written motion to withdraw my plea(s) before sentence is pronounced. I understand that for a plea held in abeyance, a motion to withdraw from the plea agreement must be made within 28 days of pleading guilty or no contest. I will only be allowed to withdraw my plea if I show that it was not knowingly and voluntarily made. I understand that any challenges to my plea(s) made after sentencing must be pursued under the Post-Conviction Remedies Act in Title 78B, Chapter 9, and Rule 65 C of the Utah Rules of Civil Procedure.

Defandant Waiver & Understanding

I voluntarily, knowingly, and intelligently waive my right to an attorney. I do not want an attorney; I want to represent myself.
I have read and I understand the foregoing rights and instructions. I understand the charge(s) and penalties. Any plea I enter is voluntary and of my own free will and choice. No force, threats, or unlawful influence have been made to get me to plead. *
Signature *

Defense Counsel (optional)

I have reviewed these rights with my client and affirm that this plea is knowingly and voluntarily made.
Defense Counsel Signature (if applicable)