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. ___
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.
___
Signature of Defendant ___
___ Date ___
Signature of Attorney for the Defendant
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
___
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 ___