IN THE ______________________
(Justice Court, Justice Court of Record, Municipal Court, City Court, City Court of Record)
 COUNTY OF _____________________, STATE OF MONTANA
                  (County)   

State of Montana

vs. 

___________________________________
		Defendant.	
Case No:   	_____________________

ACKNOWLEDGMENT AND
WAIVER OF RIGHTS	

I understand the charge(s) against me and the penalty for each charge. I am not under the influence of anything affecting my judgment, and I have not been pressured, threatened, or coerced to cause me to plead guilty or no contest, or to post and forfeit bond. It has been explained to me and I understand that I am presumed  innocent of all charges and that I have these rights:
1.	To appear before a judge;
2.	To plead ‘not guilty’ and only be found guilty after a trial if a charge is proved against me beyond a reasonable doubt;
3.	To a speedy and public trial before a judge or 6-person jury;
4.	To confront the witnesses who testify against me and to ask them questions;
5.	To present evidence in my defense at the trial and to require that witnesses attend my trial and testify on my behalf;
6.	To challenge the way in which the State has gathered evidence against me;
7.	To hire an attorney to represent me or to have an attorney appointed to represent me if any charge against me carries the possibility of jail time if I am found guilty and I cannot afford an attorney;
8.	To appeal my case to the District Court if I am found guilty at the trial; and
9.	To remain silent. I understand that if I decide not to say anything about the charge(s), my decision to remain silent may not be held against me. I also understand that if I make a statement about the charge(s) my statement may be used against me.
If I plead guilty or no contest or if I post and forfeit bond, I understand that I am giving up these rights and that one or more of these things may happen:
1.	The judge could sentence me to the maximum penalty for each charge and I could receive a more severe punishment in the future if I am convicted of the same or similar charge(s); 
2.	Certain convictions may result in loss of the right to possess firearms and ammunition, to forfeit the privilege to hunt, fish, or trap in Montana and to use State lands for recreation;
3.	I may be ordered to pay restitution for any loss suffered by a victim and to undergo counseling or education at my expense;
4.	Certain traffic offenses may add points to my driving record and if I accumulate 30 or more points on my record during any 3-year period my driving privileges will be revoked;
5.	My driving privileges may be suspended; and
6.	If I am not a U.S. citizen I may be deported, denied reentry into the U.S., or denied naturalization.

I have read and have been advised of these rights and consequences, and I have decided to give up these rights and not have a trial.  My decision has been made knowingly, voluntarily, and intelligently and is not the result of any improper influence or threats.  DO NOT SIGN THIS FORM IF YOU WANT AN ATTORNEY.  DO NOT SIGN THIS FORM UNLESS YOU HAVE READ IT AND UNDERSTAND IT.
Dated:  ____ day of ______________, _______

	_______________________________
	Defendant

cc:	____________	 City Prosecutor   	 Defendant’s attorney 
			 Defendant		 Other:  ______________________________