JV-120 (Rev. 06/07/2013)
WAIVER OF JURY TRIAL/
DEFENSE COUNSEL'S CERTIFICATE
DOCKET NUMBER
Trial Court of Massachusetts
Juvenile Court Department
Commonwealth v.
NAME OF CHILD/DEFENDANT
DIVISION
WAIVER OF RIGHT TO JURY TRIAL
(G. L. c. 119, § 55A. G. L. c. 263, § 6.)
I, the above named child/defendant, have been informed of my right to have a jury trial. I have decided to
waive that right. I have chosen to be tried by the court without a jury.
DATE SIGNATURE OF CHILD/DEFENDANT
SIGNATURE OF PARENT / GUARDIAN (IF APPLICABLE)
DEFENSE COUNSEL'S CERTIFICATE
(G. L. c. 119, § 55A. G. L. c. 263, § 6.)
I, the undersigned counsel for the above named child/defendant in the case captioned above, certify that with
regard to the waiver of the right to jury trial, that the child/defendant has not been pressured or cajoled, that the
child/defendant is not intoxicated or otherwise rendered incapable of rational judgment; that I have conferred
with the child/defendant, and the child's parent or guardian (if applicable), and I have explained the following to
the child/defendant and the child's parent or guardian (if applicable):
That the jury consists of members of the community, and that the jury would be comprised of
either six or twelve persons selected randomly from the community at large, that the child/
defendant would have the right to participate in their selection, and that after hearing all of the
evidence, that the verdict of the jury would have to be unanimous;
That the jury must decide whether or not the child is delinquent or a youthful offender or the
defendant is guilty while the judge makes rulings of law in the course of the trial and instructs the
jury on the law, and imposes sentence in the case of an adjudication of delinquency or as a
youthful offender, or a finding of guilt; and
That when a jury is waived, the judge alone decides whether or not the child is delinquent or a
youthful offender, or the defendant is guilty in accordance with the facts and the law.
DATE
SIGNATURE OF DEFENSE COUNSEL
