| STATE OF MINNESOTA | DISTRICT COURT |
| COUNTY OF _ | _ JUDICIAL DISTRICT |
| _, | |
| Plaintiff, | |
| vs. | CONSENT TO ITV |
| APPEARANCE | |
| _, | District Court File No. _ |
| Defendant. |
I, _________, Defendant in the above-entitled action do respectfully represent and state as follows:
1. I understand that I have the right to be personally present before the presiding Judge at all stages of these proceedings.
2. I have been requested to consent to appear by ITV for the ______(hearing type)_______ hearing scheduled for __(date)__.
3. I understand that if I do not consent to appear by ITV, an in-person court appearance for that hearing will be scheduled within the time limits provided by the Minnesota Rules of Criminal Procedure or other law.
4. I hereby consent to appear by ITV for the hearing.
5. This consent may not be extended to a future hearing without my later consent.
| Dated: _ | _ |
| Signature of Defendant |
(Added effective for criminal actions commenced or arrests made after 12 o'clock midnight January 1, 2008.)