Forms provided here are for reference purposes. To download forms to fill out please visit the
Minnesota Courts website.
1. | | My full name is _______________ and I have been charged by Delinquency Petition in juvenile court with the offense(s) of: ____________ which would be a felony if committed by an adult. This felony carries a presumptive sentence of _______________ [range] months in prison under the Minnesota Sentencing Guidelines and applicable statutes. |
2. | | The offense(s) is alleged to have occurred on _______________ and I was 16 or 17 years old at the time, having a date of birth of __________. |
3. | | For the purpose of this waiver only, I submit there is probable cause to believe I committed the offense(s). |
4. | | I understand that I have a right to an attorney. |
5. | | The prosecutor has brought a motion for certification, and I understand I have a right to a hearing before a judge. |
6. | | At that hearing, it is my burden to show the judge by clear and convincing evidence that retaining my case in juvenile court serves public safety. I have discussed the public safety factors with my attorney. |
7. | | I understand I could present witnesses and evidence at that hearing. |
8. | | I understand I could cross-examine all witnesses who testify for the state. |
9. | | I understand I could present arguments against certification. I further understand that if I prevailed at the certification hearing, the court must order that my case proceed as an extended jurisdiction juvenile prosecution. |
10. | | I understand that by waiving my right to a hearing I agree that my case can proceed to adult court for a jury trial on the above-named offense(s) and be subject to the penalties under Minnesota Sentencing Guidelines and criminal statutes. |
11. | | I have discussed with my attorney and understand the potential maximum penalties under the Minnesota Sentencing Guidelines and criminal statutes. I have discussed and understand that the charged offenses presume an executed prison sentence. We have discussed and I understand that there may be sentencing departures, either upward if the court finds aggravating circumstances, or downward if the court finds mitigating factors in the case. |
| | □ No promise of any agreement has been made to me. |
| | □ The following agreement has been reached in exchange for my waiver: |
12. | | I understand I have a right to discuss my case with my parent(s), legal guardian(s), or legal custodian(s), and I have either done so or waive my right to do so. |
13. | | I understand the court will find that I represent a danger to the public safety if kept within the juvenile system and will order certification for trial as an adult. |
14. | | If a psychological evaluation has been completed, I understand I may request additional psychological evaluations and explore alternative treatment programs to find a suitable juvenile disposition option and demonstrate to the court that I do not represent a danger to the public safety if returned to the extended jurisdictional juvenile system. |
15. | | Based upon all of this information and investigation, I am choosing to waive or give up my right to have a contested certification hearing. |
16. | | No threats have been made to coerce me into waiving these rights. No promises have been made to me except as set forth in paragraph 11. |
17. | | I am waiving or giving up my rights freely and voluntarily. I have had sufficient time to discuss my rights and options with my attorney. |