Commonwealth of Pennsylvania
V.
Waiver of Jury Trial
Docket No: CP-01-CR-___-20___
Are you completely satisfied with the representation and legal advice of your attorney?
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Has anybody forced you, or attempted to force you, in your decision to waive constitutional right to a trial by jury?
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Has anybody promised you anything for waiving your constitutional right to a trial by jury?
.
Are there any further questions concerning your right to a jury trial, your waiver of that right, or the charges against you, which you would like to ask the court?
.
Signature of Defendant Date
As attorney for the defendant, I, _____, hereby certify that I have advised my client of the rights and the meaning of the questions contained in this form and it is my belief that the defendant understands these rights and that it is the defendant's voluntary decision to proceed non-jury.
Signature of Attorney for the Defendant
Date