IN THE CIRCUIT COURT OF THE
EIGHTEENTH JUDICIAL CIRCUIT, IN AND
FOR SEMINOLE COUNTY, FLORIDA
STATE OF FLORIDA, CASE NO._________________________
(Fla. R. Crim. P. 3.171)
The undersigned defendant withdraws the previously entered plea(s) of not guilty and tenders a
plea of ( ) guilty, ( ) no contest as follows:
CASE NUMBER OFFENSE MAXIMUM SENTENCE MINIMUM MANDATORY SENTENCE
If I am pleaing guilty, I hereby acknowledge that I am in fact guilty of the foregoing offense(s).
W hen asked by the Judge, I will provide a factual basis to support m y plea. If I am pleaing no contest, I
believe m y plea is in m y best interest and recognize that the judge will find m e guilty after they are
provided with a factual basis.
The State of Florida and I have agreed upon the following sentence:
CASE NUMBER OFFENSE SENTENCE
If probation is part of m y sentence the court m ay im pose conditions authorized by law, including
restitution, public service and, unless conditions are specifically attached hereto, those conditions are by
this agreem ent left to the discretion of the court. I further understand that statutory costs m ay be im posed
as a part of m y sentence unless the court waives those costs.
I have the right to plead not guilty and to be tried by a jury with the assistance of a lawyer, the right
to com pel attendance of witnesses on m y behalf, the right to confront and cross exam ine witnesses
against m e, the right to present defenses to the jury, and the right to take the witness stand and testify on
m y own behalf. I also have the right not to take the witness stand and cannot be com pelled to incrim inate
m yself. I give up these rights by entering this plea.
I understand that if I enter a plea without reserving the right to appeal, I will give up m y right to
appeal all m atters relating to the judgm ent, including the issue of guilt or innocence except fo the lim ited
review available by collateral attack. I also give up m y right to appellate review on any pretrial rulings
m ade by the court unless such right is specifically reserved in this agreem ent.
I understand that I m ay be asked questions by the Judge under oath about this plea and that m y
answers, if untruthful, m ay be used against m e later in a perjury prosecution.
I enter this plea freely and voluntarily. No one has forced, threatened or coerced m e into entering
I am satisfied with m y lawyer’s representation and I have fully discussed m y cases, including any
defenses I m ay have, and the contents of this plea agreem ent.
I have discussed the physical evidence that m ay be available in m y case with m y lawyer, including
physical evidence that m y tend to prove I did not com m it the crim e(s) charged, such as DNA evidence. I
am satisfied there is no such evidence in m y case or I hereby waive any claim of innocence that m ay be
established by the physical evidence, including DNA testing.
I am relying upon no prom ises or assurances except as contained in this agreem ent.
I understand that I enter a plea to a felony offense or a sex offense I m ust register as a convicted
felon or as a sex offender as required by law. If I am pleading to a sex offense, I have been advised by
m y lawyer that m y liberty m ay be restricted, including but not lim ited to, where I m ay live, where I m ay
work, and with whom I m ay have contact.
I understand that if I am pleaing guilty or no contest to a sexually violent offense or a sexually
m otivated offense, or if I have previously been convicted of such an offense, I m ay be subject to
involuntary civil com m itm ent as a sexually violent predator upon com pletion of any prison sentence.
I understand that if I am not a United States citizen, entry of this plea m ay subject m e to
deportation by the United States Im m igration Service.
I do not suffer from physical or m ental disabilities to the degree that I am incapable of
understanding this agreem ent, the nature of the proceeding against m e, or assisting m y lawyer in m y
behalf. I am not under the influence of alcohol, or any drug at this tim e.
I hereby give up m y right to a speedy trial.
If I am not in custody, I acknowledge that part of the plea agreem ent in this case includes m y
continued release pending sentencing on bond, pre-trial release or release on recognizance. I understand
that this portion of the plea agreem ent is conditioned upon the following requirem ents:
(1) If a pre-sentence investigation (PSI) has been ordered, I m ust appear at the Departm ent
of Corrections office as directed by the court and schedule a PSI not later than the first
business day following the entry of m y plea.
(2) I m ust obey the order of the court requiring m e to undergo drug or alcohol screening or for
other evaluation if such an order has been m ade in m y case.
(3) I m ust appear on tim e for all appointm ents with the assigned probation officer and not be
under the influence of any illegal drugs or alcohol.
(4) I m ust appear in court on tim e for sentencing and not be under the influence of any illegal
drugs or alcohol.
I realize that this agreem ent will be provisionally accepted upon entry of m y plea and is subject to
being accepted or rejected by the Judge at any tim e prior to the sentence being im posed, and if it is
rejected for any reason other than for a breach of this agreem ent, I m ay withdraw m y plea and go to trial.
I acknowledge receipt of a copy of the notice for m y sentencing date. I understand and agree that
if I fail to com ply with any of the conditions set forth above I will have breached m y plea agreem ent. In
that event, I will not be allowed to withdraw m y plea and the Judge m ay sentence m e to any sentence
authorized by law for the offense(s) to which I have pled.
Assistant State Attorney Defendant’s signature
Defendant’s Date of Birth ____/____/____
CERTIFICATE OF ASSISTANT STATE ATTORNEY
I HEREBY CERTIFY that I have disclosed item s of physical evidence which m ay be favorable to
the defendant, including any possible DNA evidence, by list or description or this inform ation will be
disclosed at the tim e of entry of the plea.
Assistant State Attorney
Florida Bar # ______________
CERTIFICATE OF DEFENSE ATTORNEY
I HEREBY CERTIFY that I have fully discussed this case and this plea agreem ent with the
defendant, including the nature of the charges; their elem ents; the evidence of which I am aware; any
possible defenses; the m axim um and m inim um penalties which m ay be im posed; the probable guideline
range; and the defendant’s right to appeal.
I am not aware of any DNA testing that m y exonerate the defendant.
Florida Bar # ______________
SW ORN TO, SIGNED, AND FILED IN OPEN COURT IN MY PRESENCE AND
PROVISIONALLY ACCEPTED BY ME THIS _______ DAY OF _________________________, 20_____.