Revised 8/2018
GUILTY PLEA COLLOQUY
INSTRUCTIONS TO DEFENDANT’S COUNSEL AND/OR DISTRICT ATTORNEY
IF THE DEFENDANT CANNOT READ, WRITE OR UNDERSTAND THE ENGLISH
LANGUAGE, THIS FORM SHOULD NOT BE USED AND THE DEFENDANT SHOULD
APPEAR BEFORE THE COURT FOR THE ENTIRE PLEA COLLOQUY.
THIS FORM SHOULD BE COMPLETED AND SIGNED BY THE DEFENDANT. IF THE
DEFENDANT SIGNS IT AND UNDERSTANDS WHAT THEY ARE DOING, DEFENSE
COUNSEL SHALL SIGN IT BEFORE THE GUILTY PLEA IS TAKEN, THEN ENTER IT AS
AN EXHIBIT IN THE RECORD AT THE TIME THE COURT ACCEPTS THE PLEA.
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Defendant Initial _______
IN THE COURT OF COMMON PLEAS OF YORK COUNTY, PENNSYLVANIA
CRIMINAL DIVISION
COMMONWEALTH : CASE NUMBER(S):
Vs _________________________
______________________ _________________________
_________________________
DIRECTIONS CONCERNING THE ENTERING OF A GUILTY PLEA
You are present before this Court because you or your lawyer has indicated your
desire to plead guilty to some or all of the criminal offenses with which you have
been charged.
Please answer all of the questions on these pages fully. Most of the questions are
to be answered either YES or NO. Where facts are requested, please fill in those
facts specified in the blank space provided after the question. If you do not
understand the question, indicate this by marking an X in the blank space
provided after the question you do not understand.
After you have completed this form and signed it, if there are any portions of it
that you have indicated you do not understand, tell your attorney, the attorney
for the Commonwealth or the Judge, so that you have a chance to have it
explained to you.
If you are pleading No Contest, rather than Guilty, all references in this colloquy
to your plea of guilty (or similar language) shall be interpreted to mean no
contest.
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Defendant Initial _______
1. What is your full name? ____________________________________________________
2. What is your address? _________________________________
City ___________________ State_____ Zip Code ____________
3. If you are known by any other names or aliases, list them:
________________________________________________________________________
4. Are you a United States Citizen? Y / N
5. Are you employed? Y / N if Yes, where? _____________________
6. How old are you? ________ Date of Birth _____/_____/_____
7. What grade did you complete in school? ________________________
8. Can you read, write and understand the English language? Y / N
9. Have you ever been a patient in a mental institution, or have you ever been treated for a
mental illness? Y / N
10. Are you currently being treated for a mental illness? Y / N
11. If the answer to number 9 or 10 is Yes, please explain:
_______________________________________________________________________
12. If you are presently being treated for a mental illness, do you still feel that you can cooperate
with your attorney, understand what you are doing today, understand what these questions
mean, and know why you must answer these questions? Y / N
13. Have you consumed any alcohol or taken any drugs or medicine or any other substances
within the past twenty-four (24) hours? Y / N
14. If the answer to number 13 is Yes, please explain:
_______________________________________________________________________
15. If the answer to number 13 is Yes, are you presently under the influence of alcohol, drugs,
medicine or any other substance to a degree that you cannot understand these questions
and answer them? Y / N
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Defendant Initial _______
16. Do you understand that you are here to enter a guilty plea to some or all of the charges
against you? Y / N
17. Has your attorney explained to you all of the elements of the crime(s) in question and the
facts that must be established in order for you to be found guilty of the crime(s) to which
you are entering your guilty plea? Y / N
18. Do you admit that you committed the crime(s) to which you are entering your plea of guilty?
Y / N
19. Do you understand that you are presumed to be innocent and have the right to stand trial,
however, by pleading guilty you waive your right to trial and you lose your presumption of
innocence? Y / N
20. Do you understand that you have the absolute right to have your guilt or innocence
determined in a trial before a jury which involves the following:
a. That jury panels in York County are selected at random from the citizens of York
County? Y / N
b. That you and your attorney would participate in selecting from this panel, the
particular twelve (12) jurors who would hear the evidence and decide your guilt or
innocence? Y / N
c. That only impartial and unprejudiced jurors would be qualified to sit and hear your
case? Y / N
d. That the Commonwealth has the burden of introducing testimony or other evidence
which will convince the twelve jurors unanimously of your guilt beyond a reasonable
doubt, which is a doubt that would cause a reasonable, careful, and sensible person
to hesitate before acting upon a matter of importance in his/her own affairs?
Y / N
e. That your attorney can question those witnesses to test their credibility? Y / N
f. That you can testify, call witnesses, or introduce other evidence to contradict the
Commonwealth's evidence and/or support your innocence, but you are not required
to do so? Y / N
g. That if you do not testify, call witnesses, or introduce other evidence, no adverse
inference may be drawn by the jury and you will still be presumed innocent?
Y / N
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Defendant Initial _______
h. That if the jury is not unanimously convinced of your guilt beyond a reasonable
doubt, you cannot be found guilty? Y / N
i. That if the jury is unanimously not convinced of your guilt beyond a reasonable
doubt, you will be found not guilty? Y / N
21. Do you understand that you can request a Judge try your case instead of a jury, and
although that request may not be granted, if it is granted, the following would apply:
a. That the Judge assigned would act as both Judge and jury? Y / N
b. That the same rules of law, evidence and procedure as in a jury trial, would be
followed? Y / N
c. That the Judge must be convinced of your guilt beyond a reasonable doubt
before you can be found guilty, and if he is not convinced, you will be found not
guilty? Y / N
22. Do you understand that in entering your guilty plea, you are accepting that you are properly
before the Court on those offenses to which you plead, and that you give up and waive your
right to raise, both before this Court or an Appellate Court, procedural or fundamental error,
irregularities, or unlawful acts or violations of your Constitutional rights by the
Commonwealth personnel in investigating, filing, proceeding with, and presenting at the trial
the charges against you? Y / N
23. Do you understand that if you have raised any of these matters that your guilty plea will
terminate your right to be heard on them? Y / N
24. Do you understand that you have the right to be represented by an attorney, if you cannot
afford an attorney, one could be appointed to represent you without charge, before, during,
and after trial and on appeal to the appellate courts? Y / N
25. Do you understand that if you cannot afford to pay proper costs necessary to present your
position, these costs would be paid for you? Y / N
26. Do you understand that for a misdemeanor or felony, the Court may impose a sentence in
accordance with the Sentencing Guidelines established by the legislature of the
Commonwealth of Pennsylvania that place a suggested length of sentence for the type of
crime and increase that length of sentence if the person sentenced has been previously
convicted of other crimes, either as a juvenile or an adult, and that the maximum sentence
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Defendant Initial _______
or sentences of confinement and/or fine or fines applicable to the crime or crimes to which
you are entering your plea(s) are as follows:
CHARGE
Grade
MAXIMUM TERM OF
CONFINEMENT
MAXIMUM
FINE
(Either confinement or a fine or both may be imposed by the Court)
a. Do you understand that if you are being sentenced on more than one count, the sentences
could be consecutive to each other? Y / N
b. Do you understand that if you are currently serving another sentence, the sentence(s) you
receive for your plea(s) today could be consecutive to any other sentences you are already
serving? Y / N
c. Do you understand that the total possible aggregate sentence you could receive for your
plea(s) today, if all sentences were to be made consecutive, would be
___________________ (specify months or years and total fines)? Y / N
27. Are you presently on probation or parole? Y / N
28. If you are on probation or parole, do you understand your guilty plea means you have
violated that probation or parole and you could be sentenced on the violation as a result of
your guilty plea? Y / N
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Defendant Initial _______
29. Do you understand that if your guilty plea(s) is accepted and you are sentenced, if you come
before a Court for sentencing on another crime, you may receive a more severe sentence
because you will have been sentenced on this crime to which you are now pleading guilty?
Y / N
30. Have you and/or your attorney agreed with the Assistant District Attorney concerning the
charges to which you will plead and/or the length of sentence that will be imposed on these
charges in exchange for your guilty plea? Y / N
31. If your answer to number 30 was Yes, state the agreement:
32. Are you aware that the Judge does not have to sentence you in accordance with the terms
of the pleas and sentence that you, your attorney, and the Assistant District Attorney may
have negotiated? Y / N
33. Do you understand if the Judge does not accept that plea agreement, you may withdraw
your guilty plea? Y / N
34. Do you understand that if your plea is accepted today, sentencing in this case, including
probation violation or parole violation sanction or sentence, may be imposed by any judge
as assigned by the District Court Administrator? Y / N
35. Other than the plea agreement negotiated for you by yourself or your attorney stated in
question 31, have any other promises been made to you to convince you to enter a plea of
guilty? Y / N
36. Has anybody forced, threatened, or coerced you directly or indirectly to enter guilty plea(s)?
Y / N
37. Are you doing this of your own free will? Y / N
38. After you enter your guilty plea(s) and it is accepted by the Court, you still have the right to
appeal your conviction. Your appeal for a guilty plea is limited to one or all of four (4)
grounds: 1) your guilty plea(s) was not voluntary; 2) the Court did not have jurisdiction (no
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Defendant Initial _______
authority) to accept your plea, because, in other words, the crimes to which you are pleading
guilty did not occur in York County; 3) the judge's sentence is illegal because it is beyond
the maximum penalties authorized by law; and 4) your attorney was not effective in
representing you. Do you understand the four (4) reasons for an appeal? Y / N
39. In order to appeal your conviction after a guilty plea, you must file a written document called
a Petition to Withdraw Guilty Plea and state any or all of the grounds in question 38 as the
reason for your petition to withdraw your plea. If you want the Court to reconsider or reduce
your sentence, you must file a written document called a Motion for Reconsideration of
Sentence. This must be done within ten (10) days from the date you are sentenced.
If you cannot afford an attorney to represent you or if your basis of appeal is that the
attorney who represented you at your guilty plea was ineffective, you have the right to have
another attorney appointed to your case to raise the claims in question 38 or reconsideration
of sentence.
If your petition to withdraw your guilty plea or motion for reconsideration of sentence is
denied, you then have thirty (30) days to file an appeal of that denial with the Superior
Court of Pennsylvania. If you do not file a Petition to Withdraw Guilty Plea or Notice of
Appeal to the Superior Court within thirty (30) days, you give up your right to ever again
raise the issue that your sentence was improper or that your guilty plea was not voluntarily
or intelligently entered. Do you understand the meaning of the various appeal rights that
have just been explained? Y / N
40. Do you understand that before sentencing, you may have the right to: a) make any relevant
statement on your own behalf, b) have your attorney do so; and c) have the right to examine
the pre-sentence investigation report presented to the Court and the right to correct any
error or omissions of such report. Y / N
41. Have you had an adequate opportunity to talk to your attorney before reading this form and
deciding to enter your guilty plea(s)? Y / N
42. If you did not understand any part of this form, has your attorney advised you on such
matters? Y / N
43. Are you satisfied with your attorney's representation of you in this case? Y / N
44. Is it your decision and your decision alone to enter a guilty plea(s)? Y / N
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Defendant Initial _______
45. Do you thoroughly understand that you do not have to enter a guilty plea, but if you do, you
give up all rights as previously explained? Y / N
____________ ________________________________________________________
Date Defendant's signature
I _______________________________________________, Esquire, Attorney for the above
named defendant, represent to the Court that I have advised my client of the meaning of this
Guilty Plea Colloquy; that it is my belief that they understand the questions and have voluntarily
and knowingly answered the questions; that I have discussed their rights to go to trial and would
do so if they wished; and that the defendant fully understands what they are doing by entering
their plea of guilty and the possible consequences thereof.
________________________________________________________
Attorney for the Defendant
click to sign
signature
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signature
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Defendant Initial _______
DIRECTIVE TO REPORT
I understand that if I am placed on probation, parole or intermediate punishment or receive a
sentence of time served by the Court, I must report to the York County Probation Department
located at the York County Judicial Center, 2nd Floor, 45 N. George Street, York, PA within two
(2) business days.
I further understand that if I fail to report to the Probation Department within two (2) business
days, a probation/parole warrant will be issued for my arrest and I may be incarcerated if found
to have willfully failed to appear.
____________ ________________________________________________________
Date Defendant's signature