Revised: February 26, 2013
ADVICE OF RIGHTS FORM
United States of America v. Cr. (LTS)
I have received and read a copy of the indictment or information and understand the nature
of the charges made against me. I have had the opportunity to tell my lawyer all I know about the
matters referred to in the indictment or information.
I understand the nature of the charges against me, my constitutional rights, and the
punishment that could be imposed by the Court upon my plea of guilty, including: any maximum
and mandatory minimum terms of imprisonment; the effect of any term of supervised release that
may be imposed; the possibility of an order of forfeiture; the possibility of an order of restitution if
any financial injury was caused by the offense; the fact that the Court must consider any applicable
sentencing guidelines as well as the other factors enumerated in Title 18, United States Code, Section
3553(a), in imposing sentence; and the fact that the Court may depart from the sentencing guidelines
in some circumstances.
I understand that if I plead not guilty to any count or counts in the indictment or information:
• I would be presumed under the law to be innocent of the charges against me
in such count or counts.
• I would be entitled to a speedy, public trial by an impartial jury in which the
burden would be upon the Government to establish my guilt beyond a
reasonable doubt to the satisfaction of all 12 jurors.
• Upon such trial (1) I would be entitled to remain silent and no inference could
be drawn against me because of my silence; (2) I could, if I wished, testify on
my behalf; (3) I would be entitled, through my lawyer, to confront and
cross-examine all witnesses against me; and (4) I would be entitled to
compulsory process of the Court to obtain witnesses to testify and evidence
to be offered in my defense.
I understand that if my plea of guilty to any count or counts is accepted by the Court, I will
give up the foregoing rights with respect to such count or counts and the Court will have the same
power to sentence me as if a jury had brought in a verdict of guilty with respect to such count or
counts.
My decision to plead guilty is freely and voluntarily made. I have not been induced to plead
guilty to any count by any promises other than those contained in any written plea agreement that
I have signed, if such an agreement exists. No one has promised me that I would receive leniency,
a lesser sentence, or any other consideration if I pleaded guilty instead of going to trial. I have not
been induced to plead guilty by any force or coercion.
I understand that, if my guilty plea is accepted and I am adjudged guilty, that adjudication
may deprive me of valuable civil rights, such as the right to vote, the right to hold public office, the
Advice of Rights Form 1
right to serve on a jury, and the right to possess any kind of firearm, if I currently have or could
otherwise attain such rights. If I am not a citizen of the United States, I have had an opportunity to
discuss the possible immigration consequences of my plea with my lawyer; I understand that, if I
plead guilty, there may be adverse effects on my immigration status, including further detention
following completion of my sentence and removal or deportation from the United States.
I am pleading guilty because after discussing the case with my attorney I believe that I am
guilty. I am satisfied with how my lawyer has represented me.
I have had a full opportunity to discuss with my lawyer whether there are any meritorious
defenses to the count or counts to which I am pleading guilty. I understand that, by pleading guilty,
I am giving up the right to assert any such defenses.
I have had a full opportunity to discuss with my lawyer whether there is a basis to seek
suppression of some or all of the evidence against me on the ground that my constitutional rights
were violated. I understand that, by pleading guilty, I am giving up the right to seek suppression of
any of the evidence against me, unless the Court, as a condition of my guilty plea, specifically
permits me to retain the right to appeal the denial of any suppression motion I have made or joined.
I am not under the influence of any substance, such as medication, narcotics or alcohol, that
would affect my ability to understand the nature and consequences of my action in pleading guilty.
I have read and fully understand the foregoing statement.
Signature of Defendant
Dated:
Signature of Interpreter
I, the lawyer for the above-named defendant, have reviewed the foregoing with the defendant,
have explained to the defendant the nature of the charges against him or her; his or her constitutional
rights; the punishment that could be imposed upon entering a guilty plea; and, if applicable, the
possible immigration consequences of his or her guilty plea. The defendant has had a full
opportunity to discuss with me whether there are any meritorious defenses to the count or counts to
which the defendant is pleading guilty. I have explained to the defendant that, by pleading guilty,
he or she is waiving the right to assert any such defense. The defendant has also had a full
opportunity to discuss with me whether there is a basis to seek suppression of some or all of the
evidence against him or her on the ground that his or her constitutional rights were violated. I have
explained to the defendant that, by pleading guilty, he or she is giving up the right to seek
suppression of any of the evidence against him or her, unless the Court, as a condition of the guilty
plea, specifically permits the defendant to retain the right to appeal the denial of any suppression
motion he or she may have made or joined.
Dated:
Signature of Lawyer
Advice of Rights Form 2
