THE STATE OF TEXAS VS. (ACCUSED/DEFENDANT) CHARGES(S

CAUSE NO. ARINCIDENT NC
THE STATE OF TEXAS
IN THE COUNTY/DISTRICT COURT
§
§
§
§
§
§
VS.
(ACCUSED/DEFENDANT)
CHARGES(S):
AT LAW NO._______
JUDICIAL DISTRICT COURT
NUECES COUNTY, TEXAS
RECORD OF PROCEEDINGS PURSUANT TO ARTICLE 15.17
CODE OF CRIMINAL PROCEDURE
1.
You are warned and advised as follows:
1, You have the right to remain silent.
2. You have the right to hire your own attorney.
3. You have the right to request the appointment of an attorney if you cannot afford to pay one.
4. You will be allowed a reasonable time and opportunity to consult with your attorney.
5. You have the right to have an attorney present during an interview with peace officers.
6. You have the right to terminate the interview at any time.
7. You are not required to make any statement.
8. You are advised that any statement by you may be used against you at trial in court.
9. You have the right to have an examining trial.
II.
The following procedures are now to request a court-appointed attorney:
1. An application needs to be completed to determine if you qualify for a court appointed attorney.
2. Assistance will be provided upon request to assist in filling out the application.
3. Your application needs to be signed.
4. Your application contains an affidavit that is declaration or statement of true facts made by you voluntarily and confirmed by
oath before a person having authority to administer such oath.
5. You must show in your application that you cannot afford to pay an attorney.
6. If you qualify, an attorney will be appointed and you will be given the name and telephone number so you can communicate with
each other.
7. The Court appointed attorney should contact you within 24 hours.
III.
By my signature, I acknowledge being informed of the charge(s) to be filed or pending against me of and of my rights and
warnings as set out above herein. It has been explained to me and I understand the range of punishment for Class A and B
misdemeanors. I have been advised by the Magistrate or Judge of my right to representation by an attorney in the trial of the
charge(s) pending against me. The Court has advised me of the dangers and disadvantages of self representation and that if I choose
to represent myself I do so at my own peril and with the understanding that I am responsible for knowing the law and procedures
associated with such representation. I further understand that my signature to this document is not an admission of guilt.
I advise the Magistrate of my choice at this time by placing my initials by either (a) (b) (c) or (d):
a) I am without means to employ an attorney of my own choosing, and I hereby ask the Court to appoint an attorney for me.
b) I want to retain/employ my own attorney at this time and plead Not Guilty. I understand that I will get a trial setting and that I
am responsible for any deadlines set if I do not employ an attorney before such deadlines are reached.
_________(c) I want to represent myself in this case and plead Not Guilty. I hereby waive my right to an attorney and request that the
Court proceed with my case without an attorney being appointed for me.
_________(d) I do not want to request a court appointed attorney or retain an attorney on my own. I have been advised by the Court of my
right to representation by an attorney in this case pending against me. I have been further advised that if I am unable to afford
an attorney, one will be appointed at no cost. With this understanding J hereby waive my right to an attorney and request
that the Court proceed now with my case without an attorney being appointed for me. I further wish to discuss this case
with the State's attorney at this time.
(Accused/Defendant's Signature)
This instrument was acknowledged before me, the undersigned Magistrate/Judge of Nueces County, Texas, on the
,20l5 at
o'clock
in. by the above named person.
_____
day of
________
A: I informed the Accused/Defendant of the above warnings and the charge(s) filed, and probable cause
(does/does not) exist.
B: I have informed the Accused/Defendant of the procedure for requesting court appointed counsel and assistance has been made available
to assist in completing any application.
C: If the Accused/Defendant has waived his/her right to an attorney, I have determined that it was voluntarily and intelligently made,
electing to represent himself/herself, after I warned of the dangers and disadvantages of self representation.
_______
Magistrate/Judge
CAUSE NO. ARINCIDENT NO,
EL ESTADO DE TEXAS
EN LA CORTE DE CONIMDO/DISTRITO
VS.
AT LAW NO._______
JUDICIAL DISTRICT COURT
(ACCUSED/DEFENDANT)
CHARGES(S):
NUECES COUNTY, TEXAS
REGISTRO 1W PROCEDIMIENTOS EN VIRTUD DEL ARTICULO 15.17
CODIGO BE PROCEDIMEENTO PENAL
L
Se advirtiO y aconsejé como sigue:
1. Usted tiene ci derecho a guardar siiencio.
2. Usted tiene ci derecho de contratar a su propio abogado.
3. Usted tiene derecho a solicitar ci nombramlcnto dc in abogado si usted no puede pagar mo.
4. Se ic permitirá un tempo razonabie y In oportunidad de consuitar con su abogado.
5. Usted ticne ci derecho a letter an abogado prescntc durante una entrevista con oficialcs de paz.
6. Usted tiene ci derecho a termunar la entrevisla en cuaiquier momento.
7. Usted no debe hacer nunguna deciaraciOn.
8. Se rccomicnda que cuaiquier dcciaracion puedc usar en an contra cii ci juicio en la corte.
9. Usted tiene ci derecho am juicio per jucz.
11.
Los siguientes procedimientos son ahora solicitar a un abogado de oficio:
1. Una ap!icaciOn debe reaiizarse para dctcrminar si usted caiffica para an tribunal nombrado abogado.
2. Sc prcstará asistcncia a pcticiOn para ayudar a ilcnar In soiicitud.
3. Sc aphcaciOn ncccsita 5cr firmado.
4. La apiicaciOn contiene una declaraciOn jurada que es Ia dcciaración o dcclaraciOn de hechos verdaderos que usted
voiuntariamcnte y confirmado porjuramcnto ante una persona que tiene autoridad para administrar taijuramcnto.
5. Sc debe mostrar en su aplicacian que no pucdc permitirse pagar a un abogado.
6. Si califica, sera nombrado an abogado y se Ic dará ci nombrc y nñmcro tcicfonico tan usted pudde comunicarse con otros.
7. El Tribunal nombrado abogado debe en contacto con usted dcntro dc 24 hums.
M.
Con mi firma, reconozco set informado dc ios cargos a 5cr prcscntadas o pcndicntcs contra ml ymis derechos y advcrtcncias como
se tücra arriba en ci prcscnte. Sc me ha explicado y cnticndo ci rango dc In pcna para dclitos mcnorcs dc ciasc A yB. He sido
informado per ci magistrado ojucz de mi derecho a rcpresentaciOn por un abogado en ci juicio dc los cargos pcndicntcs contra ml.
La cone ha ascsorado a ml dc ios pchgros y dcsvcntajas dc la rcprcscntaciOn del uno mismo y que si dccido rcpresentarmc a ml
mismo lo hago per mi propia cucnta y riesgo y cone! entcndimiento dc que soy rcsponsable por conocer La icy ylos procedimicntos
asociados a dicha rcprcscntación. Enticndo que ml firma en este documcnto no es una admisión dc cuipa.
Tc aconscjo ci magistrado de ml elecciOn cii este momento al coiocar mis inicialcs per cualquicr (a) (b) (c) o (d):
a) Estoy sin mcdios para cmpicar a an abogado dc ml propia ciecciOn, y por este mcdio pido at Tribunal que dcsignc a an
abogado para ml.
b) Quicro rctcncr/cmpicar a mi propio abogado en este momento y no culpable. Enticndo que voy a letter an ajustc dc prueba y
que soy rcsponsablc de cuaiquier piazos fijados si no emplear a an abogado antes dc liegar a csos plazos.
________(c) Quiero rcprcsentarme a ml rnismo en care caso y no culpable. Par Ia presente renuncio ml derecho a un abogado y
solicitar que In corte proceda con mi caso sin un abogado siendo designado para ml.
d) I no quicrc pcdir an tribunal designado abogado ni retener a on abogado por mi cuenta. He sido informado por ci Tribunal de
mi derecho a reprcsentaciOn per un abogado en este caso pcndicnte contra ml. He sido informado mãs que si no puedo pagar a
on abogado, uno nombrado sin costo aiguno. Con csta contprensiOn per este mcdio rcnuncio ml derecho a un abogado y
solicitar que la corte proceda ahora con mi caso sin un abogado sicndo dcsignado para ml. MS dcsee discutir este caso con ci
abogado del cstado en este momento.
(Accused/Defendant's Signature)
Este instruniento fee rcconocido antes que yo, ci suscrito Magistrado/Juez del Condado dc Nucccs, Texas, ci din
2015 a las
:m. per lo anterior habla nombrado persona.
dc
A: hiforme al acusado/demandado Ins advertencias anteriorcs y Ins cargos en an contra presentadas y probables causan
(no
hace/hace) existen.
B: Me he informado ci acusado/demandado del proccdimiento jurisdiccional rcquirente nombrado abogado y asistencia se ha hccho ayudar
en la reaIización de cuaiquier aplicaciOn.
C: Si ci acusado/demandado ha renunciado a su derecho a on abogado, he determinado que foe voiuntaria e inleiigcntemcntc hecho,
eiigiendo rcprcsenlar a si mismo, despuds advirtiO de Ins pcligros y desventajas de In representaciOn del um mismo.
________
Magistrate/Judge