State of Alabama
Unified Judicial System
Form UTC-20 Rev.9/96
WAIVER OF COUNSEL FOR DEFENDANT CHARGED
WITH DRIVING UNDER THE INFLUENCE (DUI)
CASE NUMBER
IN THE ________________________________________ COURT OF ________________________________ ALABAMA
(Circuit, District or Municipal) (Name of Municipality or County)
STATE OF ALABAMA MUNICIPALITY OF ____________________________________________________________________
V.__________________________________________________________________________________________________, DEFENDANT
I, _______________________________, defendant in the above-styled case, having been charged with the offense of DUI in violation of §32-5A-
191, Code of Alabama 1975, or Ordinance Number _______________duly adopting §32-5A-191, Code of Alabama 1975 and in force at the time the
offense was committed, having been informed of my RIGHT TO THE ASSISTANCE OF COUNSEL and advised that if I cannot afford counsel and I qualify
for such representation, the court will appoint counsel, DO HEREBY VOLUNTARILY AND OF MY OWN FREE WILL FOREGO AND WAIVE MY RIGHT
TO THE ASSISTANCE OF COUNSEL. I have been advised of the penalties which may be imposed upon conviction for this offense. I understand that
I may withdraw this waiver upon due notice to the court at any time, but that I will not be entitled to repeat any proceeding held or waived solely on the
grounds of a subsequent or retention of counsel. I have also been informed and understand that by waiving my right to counsel I am not hereby waiving any
of my other constitutional rights.
________________________________________________ _______________________________________________
DATE SIGNATURE OF DEFENDANT
_______________________________________________
ADDRESS
JUDICIAL ORDER
It appearing that the foregoing Waiver of Counsel is made by defendant knowingly, intelligently, and voluntarily, its is ORDERED that it
be and the same is hereby ACCEPTED, subject to further orders of the court.
It appearing that the purported Waiver of Counsel made by defendant is NOT made knowingly, intelligently, and voluntarily, the waiver
is hereby DENIED, and,
The case is continued to (Date) __________________ to afford defendant time to retain counsel.
The Order Appointing Counsel heretofore entered in this cause remains in full fore and effect.
_____________________________________________________________________________
Municipal _____________________________________________________________________________
District
Circuit
COURT OF _____________________________ _________________________ _________________
Judge Date
COURT: Original DEFENDANT: Copy
