Fillable Form 200 00365 (Vermont Judiciary)

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Form 200 00365 (Vermont Judiciary)

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200-00365 – Waiver of Extradition Process (07/2015) Page 1 of 1
STATE OF VERMONT
SUPERIOR COURT
CRIMINAL DIVISION
Unit
Docket No.
WAIVER OF EXTRADITION PROCESS
I, ____________________________________ hereby acknowledge that I am the same person charged at,
____________________________________ with the crime of ____________________________, and that I
have been informed of my rights and the nature of the process, and of the proceedings relative to my
Extradition from the State of Vermont to the ________________________, County of __________________,
and that I am entitled to be extradited and that I hereby declare my willingness to return to the jurisdiction
of ______________________, County, State of _____________________, without being under an
extradition warrant and I expressly waive my rights to be extradited herein.
I sign this waiver without being under any fear, produced by threats, willingly, freely, and voluntarily and
without any duress or persuasion of any kind being made or used upon me, and without any promise of
immunity, for the Prosecution being made to me.
Taken and Subscribed before Me.
Dated
_____________________________ __________________________________
Signature of Defendant
Dated
_____________________________ __________________________________
Superior Court Criminal Division
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Completed 15 July 2020

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