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Misdemeanor/Traffic Offenders Request Plea Agreement

2. Misdemeanor Communications Form
   Please fill out the form below to communicate with a Prosecuting Attorney regarding your case.
4. Misdemeanor Offenses Explanation
   Misdemeanor Offenses

   Please review this Misdemeanor Offenses explanation before continuing.
6. Misdemeanor Offenses Waiver*

   1. By checking this box I acknowledge that I have read and understand the Misdemeanor Offenses Document linked above.
8. First Name*
   Required
9. Middle Name*
   Required
10. Last Name*
    Required
12. Date of Birth*
    Required
13. Reply Email Address*
    This email address will be the primary form of communication with the Prosecuting Attorney's Office.
15. Ticket # / Case # / PA #
    Any of the above numbers can be used.
17. What are you charged with? If for speeding, please put exact speed cited and speed limit, i.e. 78/65.
19. Reason for Request*
21. Attorney Waiver
    If you are not represented by an attorney, you have the right to be represented by an attorney at every stage of the proceedings and, if indigent, and unable to employ an attorney, the Court will provide an attorney to represent you, if you request representation.
23. I am not currently represented by an attorney and I do not presently intend to hire an attorney.
25. I am under no obligation to contact or discuss with the Office of the Prosecuting Attorney anything about my case. I do however desire to communicate with you.
27. I know I have the right to an attorney. If I cannot afford an attorney I may be eligible for a court appointed attorney. By discussing the case with the prosecutor handling the matter, I am not waiving my right to an attorney and understand the Prosecuting Attorney’s Office is not trying to convince me either to have or not have an attorney.
29. Further, I agree and understand that no communications between myself and the Office of the Prosecuting Attorney will be admissible if this matter goes to trial.
31. Attorney Waiver Acceptance*

    1. I fully understand and agree to the terms above.
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field