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IN THE COUNTY COURT OF THE THIRTEENTH JUDICIAL (Thirteenth Judicial Circuit Court Hillsborough County)

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IN THE COUNTY COURT OF THE THIRTEENTH JUDICIAL CIRCUIT
IN AND FOR HILLSBOROUGH COUNTY, FLORIDA
CRIMINAL DIVISION
STATE OF FLORIDA
Plaintiff, Case No.:
Vs. Division: _________________
Defendant.
ACKNOWLEDGMENT AND WAIVER OF RIGHTS IN ABSENTIA
I, the undersigned defendant, am entering A PLEA OF NOLO CONTENDERE (NO CONTEST) OR
GUILTY, IN ABSENTIA, to the charges against me, and I knowledge the following:
1. I am pleading ______________________ to the charges of
______________________________ and I understand the maximum penalty provided
by law is:___________________________________________________________.
2. I understand that I have the right to be represented by an attorney at every stage of the
proceeding and, if necessary an attorney will be appointed to represent me. I have the
right to a jury trial and the right to an attorney’s help at that trial. I have the right to
compel attendance of witnesses on my behalf, the right to confront and cross-examine
witnesses against me, and the right not to testify or to incriminate myself. By pleading
guilty or nolo contendere, I understand that there will be no trial of any kind, and I am
waiving my right to a trial and will not be permitted to defend myself against the
charges.
3. I understand that by pleading guilty or nolo contendere, unless I expressly reserve the
right to appeal prior ruling of the Court, I give up the right to appeal all matters relating
to the Court’s judgment, including my guilt or innocence.
4. I understand that if I plead guilty or nolo contendere, the Judge may ask me questions
about the charges, and if I answer these questions under oath, on the record, and in the
presence of my lawyer, those answers could be used in any later prosecution for
perjury.
5. I admit that there is a factual basis for the charge(s) to which I am pleading, and feel my
plea to be in my best interests. I understand that I have a right in the courtroom to
speak to the Judge about my sentence after I have entered this plea.
6. I understand that if the Court accepts my plea to the charges listed in Paragraph 1, my
sentence will be:
The plea will be done in my absence and through my undersigned attorney.
2
7. No alcohol or drugs are affecting me now as I read and sign this form. Other than the
proposed sentence set out in Paragraph 6, no one has threatened me, made any
promises or guarantees to me, nor in any way forced me to enter this plea. I am doing
this freely and voluntarily.
8. I am represented by the undersigned attorney. I have discussed my case with my
attorney, and any questions I have had about my case have been answered to my
satisfaction. I feel my attorney has represented me to the best of their ability, and I am
satisfied with this representation.
9. I understand I have the right to appeal the judgment and sentence of the Court within
thirty (30) days from the date of sentence. I understand that if I wish to take an appeal
and cannot afford an attorney to help me in my appeal, the Court will appoint an
attorney to represent me for that purpose.
10. I understand that if I am not a United States citizen, I may be deported. I am freely
entering this plea after careful and full consideration. Under penalty of perjury, Florida
Statute 92.525, I declare I have read and fully understand this form (4 pages) and the
facts that are stated in it are true.
11. I understand that if the offense for which I am being sentenced is sexually violent or
sexually motivated crime, or if I have a prior conviction for such an offense, this plea ma
subject me to involuntary civil commitment as sexually violent predator under the
Jimmy Ryce Act.
12. I understand that if I am pleading to an enhanceable offense that this plea may be used
to enhance the level of a future charge as well as the severity of the penalty I receive
should I reoffend with another qualifying enhanceable offense.
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All of the above fingerprints are mine and were placed on this 4-page document by me on
_______________________, 20___, in the presence of ____________________________, a notary public.
Date: ______________________
______________________________________________________
(Name)
______________________________________________________
Social Security Number
Date of Birth: __________________
STATE OF FLORIDA
COUNTY OF ____________________
The foregoing instrument was acknowledged before me by means of [ ] physical presence
or [ ] online notarization this ____ day of _________________, 20___ by ___________________________,
who is personally known to me or who has produced _________________________________(type of
identification) as identification
WITNESS my hand and official seal in the state and county last aforesaid on this ____ day of
_____________________________, 20___.
______________________________________________ My commission expires:
NOTARY PUBLIC
ACKNOWLEDGMENT OF COUNSEL
I, undersigned member of the Florida Bar, hereby represent to the Court that I represent
the above-named Defendant, that I reviewed and explained the ACKNOWLEDGMENT AND
WAIVER OF RIGHTS to the Defendant, and to the best of my knowledge and belief the
Defendant fully understands its contents.
_____________________________________________________
Attorney for Defendant
Address:
Phone Number:
Florida Bar No.:
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IN THE COUNTY COURT OF THE THIRTEENTH JUDICIAL (Thirteenth Judicial Circuit Court Hillsborough County)

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Completed 29 December 2021

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