IN THE 

SEVENTH

CARBON 

JUDICIAL DISTRICT COURT 
 COUNTY, STATE OF UTAH 

STATE OF UTAH, 

: 

STATEMENT OF DEFENDANT 
IN SUPPORT OF PLEA(S) AND 

Plaintiff, 

:  CERTIFICATE OF COUNSEL 

vs. 

:  Case No. 

, 

: 

: 

Defendant. 

I, 

, hereby acknowledge and certify that I have been 

advised of and that I understand the following facts and rights: 

Notification of Charges 

I am pleading guilty or no contest to the following crimes: 

Crime & Statutory 
Provision 

Degree 

Punishment 
Min/Max and/or 
Minimum Mandatory 

A. 

B. 

C. 

D.

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I have received a copy of the (Amended) Information against me. I have read it, or 
had it read to me, and I understand the nature and the elements of crime(s) to which I am 
pleading guilty (or no contest). 

The elements of the crime(s) to which I am pleading guilty (or no contest) are: 

I understand that by pleading guilty I will be admitting that I committed the crimes 
listed  above.  (Or,  if  I  am  pleading  no  contest,  I  am  not  contesting  that  I  committed  the 
foregoing crimes).  I stipulate and agree (or, if I am pleading no contest, I do not dispute or 
contest) that the following facts describe my conduct and the conduct of other persons for 
which I am criminally liable. These facts provide a basis for the court to accept my guilty 
(or  no  contest)  plea(s)  and  prove  the  elements  of  the  crime(s)  to  which  I  am  pleading 
guilty (or no contest): 

Waiver of Constitutional Rights 

I am entering my plea(s) voluntarily. I understand that I have the following rights 
under the constitutions of Utah and of the United States. I also understand that if I plead 
guilty (or no contest) I will give up all the following rights: 

Counsel: I know that I have the right to be represented by an attorney and that if I 
cannot afford one, an attorney will be appointed by the court at no cost to me.  I understand 

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that I might later, if the judge determines I was able, be required to pay for the appointed 
lawyer’s service to me. 

  I (have not) (have) waived my right to counsel.  If I have waived my right to counsel, 

I have done so knowingly, intelligently, and voluntarily for the following reasons: 

If I have waived my right to counsel, I certify that I have read this statement and that 
I understand the nature and elements of the charge(s) and crime(s) to which I am pleading 
guilty  (or  no  contest).  I  also  understand  my  rights  in  this  case  and  other  cases  and  the 
consequences of my guilty (or no contest) plea(s). 

If I have not waived my right to counsel, my attorney is  

. 
My attorney and I have fully discussed this statement, my rights, and the consequences of 
my guilty (or no contest) plea(s). 

Jury Trial. I know that I have a right to a speedy and public trial by an impartial 

(unbiased) jury and that I will be giving up that right by pleading guilty (or no contest). 

Confrontation and cross-examination of witnesses. I know that if I were to have 
a trial, a) I would have the right to see and observe the witnesses who testify against me 
and  b)  my  attorney,  or  myself  if  I  waived  my  right  to  an  attorney,  would  have  the 
opportunity to cross-examine all of the witnesses who testify against me. 

Right  to  compel  witnesses.  I  know  that  if  I  were  to  have  a  trial,  I  could  call 
witnesses if I chose to, and I would be able to obtain subpoenas requiring the attendance and 
testimony of those witnesses. If I could not afford to pay for the witnesses to appear, the 
State would pay those costs. 

Right to testify and privilege against self-incrimination. I know that if I were to 
have a trial, I would have the right to testify on my own behalf. I also know that if I chose 
not to testify, no one could make me testify or make me give evidence against myself.  I also 
know that if I chose not to testify, the jury would be told that they could not hold my refusal 
to testify against me. 

Presumption of innocence and burden of proof. I know that if I do not plead guilty 
(or no contest), I am presumed innocent until the State proves that I am guilty of the charged 
crime(s).  If I choose to fight the charges against me, I need only plead “not guilty,” and my 
case will be set for a trial.  At a trial, the State would have the burden of proving each 

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element of the charge(s) beyond a reasonable doubt. If the trial is before a jury, the verdict 
must be unanimous, meaning each juror would have to find me guilty. 

I  understand  that  if  I  plead  guilty  (or  no  contest),  I  give  up  the  presumption  of 

innocence and will be admitting that I committed the crime(s) stated above. 

Appeal. I know that under the Utah Constitution, if I were convicted by a jury or 
judge, I would have the right to appeal my conviction and sentence.  If I could not afford the 
costs of an appeal, the State would pay those costs for me.  I understand I am giving up my 
right to appeal my conviction if I plead guilty (or no contest).  I understand if I wish  to 
appeal  my  sentence  I  must  file  a  notice  of  appeal  within  30  days  after  my  sentence  is 
entered. 

I know and understand that by pleading guilty (or no contest), I am waiving 

and giving up all the statutory and constitutional rights as explained above. 

Consequences of Entering a Guilty (or No Contest) Plea 

Potential penalties. I know the maximum sentence that may be imposed for each 
crime to which I am pleading guilty (or no contest). I know that by pleading guilty (or no 
contest) to a crime that carries a mandatory penalty, I will be subjecting myself to serving 
a mandatory penalty for the crime.  I know my sentence may include a prison term, fine, or 
both. 

I know that in addition to a fine, a ninety percent (90%) surcharge will be imposed. 
I  also  know  that  I  may  be  ordered  to  make  restitution  to  any  victim(s)  of  my  crime(s), 
including any restitution that may be owed on charges that are dismissed as part of a plea 
agreement. 

Consecutive/concurrent prison terms.  I know that if there is more than one crime 
involved, the sentences may be imposed one after another (consecutively), or they may run 
at  the  same  time  (concurrently).  I  know  I  may  be  charged  an  additional  fine  for  each 
crime I plead to.  I also know if I am on probation or parole, or awaiting sentencing  on 
another  offense  of  which  I  have  been  convicted  or  to  which  I  have  pled  guilty  (or  no 
contest), my guilty (or no contest) plea(s) now may result in consecutive sentences being 
imposend on me. If the offense to which I am now pleading guilty occurred when I was 
imprisoned or on parole, I know the law requires the court to impose consecutive sentences 
unless  the  court  finds  and  states  on  the  record  that  consecutive  sentences  would  be 
inappropriate. 

Plea agreement. My guilty (or no contest) plea(s) (is/are) (is/are not) the result of 
a plea agreement between myself and the prosecuting attorney. All the promises, duties, and 

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provisions of the plea agreement, if any, are fully contained in this statement, including those 
explained below: 

Trial  judge  not  bound.  I  know  that  any  charge  or  sentencing  concession  or 
recommendation of probation or suspended sentence, including a reduction of the charges 
for sentencing, made or sought by either defense counsel or the prosecuting attorney are not 
binding on the judge. I also know that any opinions they express to me as to what they 
believe the judge may do are not binding on the judge. 

Immigration/Deportation:  I understand that if I am not a United States citizen, my 
plea(s) today may, or even will, subject me to deportation under United States immigration 
laws  and  regulations,  or  otherwise  adversely  affect  my  immigration  status,  which  may 
include permanently barring my re-entry into the United States. I understand that if I have 
questions about the effect of my plea(s) on my immigration status, I should consult with 
an immigration attorney. 

Defendant’s Certification of Voluntariness 

I  am  entering  my  plea(s)  of  my  own  free  will  and  choice.  No  force,  threats,  or 
unlawful influence of any kind have been made to get me to plead guilty (or no contest).  No 
promises except those contained in this statement have been made to me. 

I  have  read  this  statement,  or  I  have  had  it  read  to  me  by  my  attorney,  and  I 
understand its contents and adopt each statement in it as my own. I know that I am free to 
change or delete anything contained in this statement, but I do not wish to make any changes 
because all of the statements are correct. 

I am satisfied with the advice and assistance of my attorney. 

I am ____ years of age.  I have attended school through the 

grade.  I can read 
and understand the English language.  If I do not understand English, an interpreter has been 
provided to me.  I was not under the influence of any drugs, medication, or intoxicants that 
would  impair  my  judgment  when  I  decided  to  plead  guilty  (or  no  contest).  I  am  not 
presently  under  the  influence  of  any  drug,  medication,  or  intoxicants  that  impair  my 
judgment. 

I believe myself to be of sound and discerning mind and to be mentally capable of 
understanding  these  proceedings  and  the  consequences  of  my  plea(s).  I  am  free  of  any 
5 

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mental disease, defect, or impairment that would prevent me from understanding what I 
am doing or from knowingly, intelligently, and voluntarily entering my plea(s). 

I understand that if I want to withdraw my guilty (or no contest) plea(s), I must 
file  a  written  motion  to  withdraw  my  plea(s)  before  sentence  is  announced.  I 
understand  that  for  a  plea  held  in  abeyance,  a  motion  to  withdraw  from  the  plea 
agreement must be made within 30 days of pleading guilty or no contest.  I will only be 
allowed to withdraw my plea if I show that it was not knowingly and voluntarily made. 
I understand that any challenge to my plea(s) made after sentencing must be pursued 
under the Post-Conviction Remedies Act in Title 78B, Chapter 9, and Rule 65C of the 
Utah Rules of Civil Procedure. 

Dated this 

day of 

, 2  

. 

DEFENDANT 

Certificate of Defense Attorney 

I certify that I am the attorney for  

, the defendant 
above, and that I know he/she has read the statement or that I have read it to him/her; I have 
discussed  it  with  him/her  and  believe  that  he/she  fully  understands  the  meaning  of  its 
contents and is mentally and physically competent.  To the best of my knowledge and belief, 
after an appropriate investigation, the elements of the crime(s) and the factual synopsis of 
the  defendant’s  criminal  conduct  are  correctly  stated;  and  these,  along  with  the  other 
representations  and  declarations  made  by  the  defendant  in  the  foregoing  statement,  are 
accurate and true. 

ATTORNEY FOR DEFENDANT 
Bar No.   

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6 

Certificate of Prosecuting Attorney 

I certify that I am the attorney for the State of Utah in the case against 

, defendant. I have reviewed this Statement of Defendant 

and find that the factual basis of the defendant’s criminal conduct which constitutes the 
offense(s) is true and correct. No improper inducements, threats, or coercion to encourage 
a plea has been offered defendant. The plea negotiations are fully contained in the Statement 
and in the attached Plea Agreement or as supplemented on the record before the Court. 
There is reasonable cause to believe that the evidence would support the conviction of 
defendant for the offense(s) for which the plea(s) is/are entered and that the acceptance of 
the plea(s) would serve the public interest. 

PROSECUTING ATTORNEY 
Bar No.   

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Order 

Based on the facts set forth in the foregoing Statement and the certification of the 
defendant and counsel, and based on any oral representations in court, the Court witnesses 
the  signatures  and  finds  that  defendant’s  guilty  (or  no  contest)  plea(s)  is/are  freely, 
knowingly, and voluntarily made. 

IT IS HEREBY ORDERED that the defendant’s guilty (or no contest) plea(s) to the 

crime(s) set forth in the Statement be accepted and entered. 

Dated this 

day of 

, 2 

. 

____________________________________
DISTRICT COURT JUDGE

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