WAIVER OF JURY TRIAL/
DEFENSE COUNSEL'S CERTIFICATE

DOCKET NUMBER

Commonwealth v.

NAME OF CHILD/DEFENDANT

Trial Court of Massachusetts
Juvenile Court Department

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

JV-120  (Rev. 06/07/2013)