Fillable Plea Agreement (Vermont Judiciary)

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Plea Agreement (Vermont Judiciary)

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200-00369A - Notice of Plea Agreement (02/2019) Page 1 of 2
NOTICE OF PLEA AGREEMENT
Date
SUPERIOR COURT
STATE OF VERMONT
CRIMINAL DIVISION
Unit Docket No.
The State
of
Vermont and the Defendant named above enter into the following
agreement:
Charge:
Charge:
Docket
Number:
Docket
Number:
Charge:
Docket
Number:
Amended:
Yes No
Amended:
Yes No
Amended:
Yes No
Amended
Charge
Code:
Amended
Charge
Code:
Amended
Charge
Code:
Amended Section No:
Guilty
Nolo Contendere
SENTENCE:
Amended Section No:
Guilty
Nolo Contendere
SENTENCE:
Amended Section No:
Guilty
Nolo Contendere
SENTENCE:
FINE
$
&
Surcharge
$
FINE
$
&
Surcharge
$
FINE
$
&
Surcharge
$
(Min.)
Years Months Days
(Min.)
Years Months Days
(Min.)
Years
Months Days
(Max.)
Years Months Days
Concurrent
Consecutive
(Max.) Years Months
Days
Concurrent
Consecutive
(Max.) Years
Months Days
Concurrent
Consecutive
Suspended with Probation:
Yes
No
Suspended with Probation:
Yes
No
Suspended with Probation:
Yes
No
Term of Probation: M
onths ___
Years
Treatment Credit:
Days
Out-of-State Credit:
Days
Term of Probation:
Months ____Y
ears
Treatment Credit:
Days
Out-of-State Credit:
Days
Term of Probation: ____Months ___Years
Treatment Credit:
Days
Out-of-State Credit:
Days
Local Lock-up
Credit:
Days
Local Lock-up
Credit:
Days
Local Lock-up
Credit:
Days
All Suspended except Days Months
_______ Years
All Suspended except __Days Months
_______ Years
All Suspended except Days Months
_____ Years
The parties hereby stipulate that this conviction is a violation of the Defendant's probation and, as part of this Plea Agreement,
waive further notice, separate hearing, and agree that the Court impose the following:
TOTAL SENTENCE:
Cases to be
Dismissed
by
State:
Dismissed ☐ with prejudice ☐ without predjudice
Docket #
Charge:
Docket
#
Charge:
Docket
#
Charge:
Total FINE &
Surcharges:
$
Special Probation
Conditions:
Docket
#
Charge:
Docket
#
Charge:
Report
Date:
Forthwith:
PSI Ordered? Yes No
Sex offender registration required
Defendant already on
probation?
Yes No (See Reverse for General Conditions)
Other:
In addition to any credit to which defendant is
entitled by law, the parties agree defendant shall
receive credit for treatment, out-of-state, and
local lockup as shown above.
This is a
binding
Rule 11
Agreement.
Restitution for Fish & Wildlife = $___________
I have reviewed this agreement and understand
it.
Defendant
Date (mm/dd/yyyy)
Prosecutor
Date (mm/dd/yyyy)
Defense
Attorney
Date (mm/dd/yyyy)
Judge
Date (mm/dd/yyyy)
Guardian
ad
Litem
Date (mm/dd/yyyy)
STATE OF VERMONT
v.
Defendant's Name
DOB
/ /
200-00369A - Notice of Plea Agreement (02/2019) Page 2 of 2
NOTICE OF THE POTENTIAL COLLATERAL CONSEQUENCES OF A CONVICTION
1. When you plead guilty or are convicted of an offense, you may suffer additional legal consequences beyond
jail or prison, home confinement, probation, and fines. These consequences may include:
a. Being unable to get or keep some licenses, permits, or jobs;
b. Being unable to get or keep benefits such as public housing or education;
c. Receiving a harsher sentence if you are convicted of another offense in the future;
d. Having the government take your property;
e. Being unable to serve in the military or on a jury;
f. Being unable to possess a firearm; and
g. Being unable to exercise your right to vote if you move to another state.
2. If you are not a United States citizen, a guilty plea or conviction may also result in your deportation,
removal, exclusion from admission to the United States, or denial of citizenship.
3. The law may provide ways to obtain some relief from these consequences. Contact information for
organizations that may be able to offer assistance to persons seeking relief from collateral consequences
may be found on the Internet at: http://forms.vermontlaw.edu/criminaljustice/index.cfm
.
4. Under Vermont law, a Vermont conviction may be eligible for expungement or sealing. Potentially relevant
statutes include 13 V.S.A Section 7602 and 33 V.S.A. Section 5119(g). These statutes can be found on the
Internet at:
http://legislature.vermont.gov/statutes/section/13/230/07602
http://legislature.vermont.gov/statutes/section/33/051/05119
5. Further information about the consequences of conviction is available on the Internet at:
http://www.ago.vermont.gov/divisions/criminal-division/collateral-consequences-of-conviction.php
.
6. Conviction of a crime in Vermont does not prohibit an individual from voting in Vermont.
STANDARD CONDITIONS OF PROBATION
A. You shall not be convicted of another crime or engage in criminal behavior.
B. You shall give your probation officer your home address, mailing address, telephone number, and email
address. If any of those change, you must notify your probation officer within 24 hours.
C. You shall notify your probation officer within 72 hours if you are arrested or given a citation.
D. You must meet with your probation officer at reasonable times as directed by a judge or your probation
officer. Upon request, you must allow your probation officer to visit you at reasonable times wherever you
are staying.
E. Your probation officer may restrict or prohibit travel to any state as required by the Interstate Compact For
Adult Offender Supervision.
F. You shall provide your probation officer with the location of your job and employment status. If you change
or lose your job, you must notify your probation officer within 72 hours.
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Plea Agreement (Vermont Judiciary)

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Completed 19 July 2020

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