Fillable 500 00428 - Notice Of Plea Agreement (Vermont Judiciary)

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500 00428 - Notice Of Plea Agreement (Vermont Judiciary)

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500-00428 – Notice of Plea Agreement (07/2019) Page 1 of 1
Vermont Judicial Bureau
PO Box 607
White River Junction, VT 05001
Phone: 802-295-8869
www.vermontjudiciary.org
JUD.VJB@vermont.gov
NOTICE OF PLEA AGREEMENT
PLAINTIFF
DEFENDANT
□
State of Vermont
□
City/Town of:
NAME
DOB
ORIGINAL COMPLAINT
Code: _______ Points: _____ Penalties $ _______________
Mandatory Suspension Period: ________________________
Statutory Citation: ________V.S.A. § ___________________
Violation Description: _______________________________
__________________________________________________
□ Seat Belt Violation
□ Accident Resulted from Violation (extra 2 points)
□ Fatality Resulted from Violation
REQUESTED JUDGMENT FOR PLAINTIFF
Code: _______ Points: _____ Penalties $ ________________
Mandatory Suspension Period: _________________________
Statutory Citation: ________V.S.A.
§ ____________________
Violation Description: ________________________________
___________________________________________________
□ Meets criteria for points waiver pursuant to 23 V.S.A. § 2501(b)
□ Seat Belt Violation
□ Accident Resulted from Violation (extra 2 points)
□ Fatality Resulted from Violation
DEFENDANT’S PLEA:
□
Admitted
□
No Contest
REQUESTED DISMISSALS
□ Dismiss this case as identified by the docket number at the top of this NOTICE OF PLEA AGREEMENT.
□ Dismiss the following cases: Docket No.: ____________________________ Charge code: ______________________
Docket No.: ____________________________ Charge code: ______________________
Docket No.: ____________________________ Charge code: ______________________
Settlement Conditions or Other Information:
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
Notice of Rights: Plaintiff and Defendant both have the right to a hearing on the alleged violation. Plaintiff carries the burden of proof by
clear and convincing evidence. If the burden is satisfied, then Plaintiff is entitled to judgment in its favor. If the burden is not satisfied, then
Defendant is entitled to judgment without any penalties. All judgments based on evidence presented at a hearing are appealable. Both
Plaintiff and Defendant have the right to appeal.
Notice of Waivers: By entering this agreement, both parties waive: (1) the right to hearing; and (2) the right to appeal.
Notice to Defendant to Pay Penalty: If a monetary penalty is assessed against you, you must pay the penalty within 30 days to avoid having
an additional $30.00 fee added to the judgment amount. 4 V.S.A. § 1109.
I knowingly and voluntarily enter this plea agreement and request the court to impose the terms shown above.
______________
______________
DECISION BY JUDICIAL OFFICER
The plea agreement is approved and its terms are imposed as the decision and
judgment of the court. So ordered.
Date:
______________
☐ Points are waived pursuant to 23 V.S.A. § 2501(b).
Parent/Guardian: Date:
______________
Approved as to form by Defense Attorney: Date:
______________
Docket No.:
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500 00428 - Notice Of Plea Agreement (Vermont Judiciary)

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Completed 16 July 2020

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