Commonwealth of Pennsylvania Court of Common Pleas County of Adams 51st Judicial District

Adams County Courthouse

117 Baltimore Street

Gettysburg, PA 17325

PH: 717-337-9846

Waiver of Jury Trial

Commonwealth of Pennsylvania v. ___

CP-01-CR-_____-20___

Docket No:

I, ___, the defendant, hereby waive my right to a jury trial and elect to have a judge try the case without a jury.

___

Signature of Defendant ___

___ Date ___

Signature of Attorney for the Defendant

Data I was

I, Adams County District Attorney's Office, the attorney for the Commonwealth, hereby waive the Commonwealth's right to a jury trial and elect to have a judge try the case without a jury.

___

The Court, having ascertained on the record that the defendant, knowingly and intelligently waives the right to a jury trial, he reby APPROVE / DISAPPROVE this waiver.

compt

Judge

___

Data

CPCMS 2007 (05/25)