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
Commonwealth of Pennsylvania
v.
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Docket No: CP-01-CR-20___
I, ___, the defendant, hereby waive my right to a jury trial and elect to have a judge try the case without a jury.
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Signature of Defendant
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___ Date ___
Signature of Attorney for the Defendant
Date
Date
Date
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.
Signature of Attorney for the Commonwealth
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Date
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.
Judge ___
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