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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): SUPCR 1109 FOR COURT USE ONLY TELEPHONE NO: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional) SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CRUZ 701 Ocean Street, Room 120 Santa Cruz, CA 95060 Santa Cruz Branch PEOPLE OF THE STATE OF CALIFORNIA vs. (VEHICLE CODE 14601 et. seq.; VEHICLE CODE 12500(a)) DEPARTMENT: INSTRUCTIONS Fill out this form if you wish to plead guilty or no contest to the charges against you. Initial the box for each applicable item only if you understand it, and sign and date the form on page 4. If you have any questions about your case, the possible sentence, or the information on this form, ask your attorney or the judge. RIGHT TO AN ATTORNEY 1. I understand that I have the right to be represented by an attorney throughout the proceedings. I understand that the Court will appoint a free attorney for me if I cannot afford to hire one, but at the end of the case, I may be asked to pay all or part of the cost of that attorney, if I can afford to. I understand that there are dangers and disadvantages to giving up my right to an attorney, and that it is almost always unwise to represent myself. 1. NATURE OF THE CHARGES (Complete all items you are charged with.) I understand that I am charged with a violation of Vehicle Code section(s): 2. Check if applicable - 14601 or 14601.1 or 14601.2 or 14601.5 Driving in knowing violation of a driver s license restriction, suspension, or revocation. 2. 3. Check if applicable - 14601.3 (Habitual traffic offender) Accumulating a driving record history in knowing violation of a driver s license suspension or revocation. 3. 4. Check if applicable - 12500(a) Driving without a valid driver s license. 4. 5. If applicable - I understand that I am also charged with the following other offense(s): TYPE OF OFFENSE(S) AND SECTION NUMBER(S) 6. If applicable - I am also charged with having the following other conviction(s): 5. LIST OFFENSE(S), CASE NUMBER(S) AND DATE(S) 7. I understand that if I obtain a valid driver s license, I can withdraw my pleas to driving on a suspended license and enter a new plea to Vehicle Code 12500(a), driving without a valid license, for a fine and/or jail time. 7. 8. I understand the charge(s) against me, and the possible please and defenses. 8. 6. Page 1 of 5

CONSTITUTIONAL RIGHTS 9. RIGHT TO A JURY TRIAL - I understand that I have the right to a speedy, public jury trial. At the trial, I would be presumed innocent, and I could not be convicted unless 12 impartial jurors were convinced of my guilt beyond a reasonable doubt. 10. RIGHT TO CONFRONT WITNESSES - I understand that I have the right to confront and crossexamine all witnesses testifying against me. 11. RIGHT AGAINST SELF-INCRIMINATION - I understand that I have the right to remain silent and not incriminate myself, and the right to testify on my own behalf. I understand that by pleading guilty or no contest, or admitting other conviction(s) or probation violation(s), I am incriminating myself. 12. RIGHT TO PRODUCE EVIDENCE - I understand that I have the right to present evidence and to have the Court issue subpoenas to bring into court all witnesses and evidence favorable to me, at no cost to me. 9. 10. 11. 12. RIGHTS ON CHARGES OF PRIOR CONVICTION(S) 13. If applicable - I understand that I have the right to an attorney, the right to a jury trial, the right to confront witnesses, the right against self-incrimination, and the right to produce evidence and witnesses for all of the charges against me, including other alleged conviction(s). 13. WAIVER OF RIGHTS Understanding all of the above, for all of the charges against me, including any other alleged conviction(s) or probation violation(s): 14. I give up my right to an attorney, and I choose to represent myself. (Does not apply if you have an attorney.) 15. I give up my right to a jury trial. 16. I give up my right to confront and cross-examine witnesses. 17. I give up my right to remain silent and to not incriminate myself 18. I give up my right to produce evidence and witnesses on my own behalf. 14. 15. 16. 17. 18. SENTENCES FOR DRIVING IN VIOLATION OF A LICENSE SUSPENSION, REVOCATION, OR RESTRICTION Vehicle Code Sec. First Offense Second or Subsequent Offense 14601 5 days to 6 months in jail, and a fine of $300-$1000. 10 days to 1 year in jail, and a fine of $500 to $2000. 10 days in jail required if probation is imposed. Page 2 of 5

Vehicle Code Sec. First Offense Second or Subsequent Offense 14601.1 Up to 6 months in jail, and a fine of $300-$1000, or both. 5 days to 1 year in jail, and a fine of $500- $2,000. 14601.2 10 days to 6 months in jail, and a fine of $300-$1000. 10 days in jail required if probation is imposed. -If I have been designated as a habitual traffic offender within 3 years of this conviction, I will, in addition, be sentenced to serve 180 days in jail and to pay a $2,000 fine. 30 days to 1 year in jail, and a fine of $500 to $2000. 30 days in jail required if probation is imposed. 14601.5 Up to 6 months in jail, or a fine of $300 to $1,000 or both. 10 days to 1 year in jail, and a fine of $500 to $2,000. Note- Sec. 14601.3 also constitutes a prior conviction for this offense. 14601.3 30 days in jail, and a fine of $1,000. 180 days in jail, and a fine of $2,000. ADDITIONAL PENALTIES (Ignition Interlock Device) 19. I understand that if I am convicted of a violation of section 14601.2, or if the original charge was for a violation of that section but I am pleading to section 14601, 14601.1 or 14601.5, the Court will require me to install an ignition interlock device (IID) on any vehicle that I own or operate for a period of up to three years. Installation of this device, which prevents the vehicle from starting if I have alcohol in my body, does not authorize me to drive without a valid driver s license. Failure to install the IID shall result in the suspension of my driver s license by the DMV. 19. CONSEQUENCES OF PLEA OF GUILTY OR NO CONTEST 20. I have read and understood the penalty charts which list the minimum and maximum penalties for the offense(s) I am charged with (See item No. 27 for the offenses not listed in the charts.) 21. I understand that in addition to the fine, the Court will add assessments which will significantly increase the amount I must pay. I will also be ordered to make restitution and to pay a restitution fine of $100 to $1000, unless the Court finds compelling and extraordinary reasons not to do so. 22. I understand that in addition to any other penalty, the Court may impound my vehicle for an additional 6 months for a first conviction of section 14601 et seq, or up to 12 months for a second or subsequent violation. 23. I understand that my vehicle will be subject to forfeiture as a nuisance if I drive in violation of a license suspension or revocation (V.C. 14601 et seq.) or without a license (V.C. 12500(a)) and I am the registered owner of the vehicle. 24. I understand that if I am not a citizen, a plea of guilty or no contest could result in my deportation, exclusion from admission to this country, or denial of naturalization. 20. 21. 22. 23. 24. Page 3 of 5

25. I understand that any plea entered in this case may be grounds for revoking probation or parole which has previously been granted to me in any other case. PENALTIES FOR OTHER CHARGES 26. If applicable - I understand that the possible consequences for the offense(s) charged, which are not listed on the penalty charts on pages 2, include the following: 25. VC 12500(a) 0 6 months $0 $1000 A jail sentence may be imposed depending on the basis for the license suspension and/or any prior convictions 26. 27. Other Terms and conditions of this plea agreement: 27. PLEA(S) 28. I hereby freely and voluntarily plead (circle one) GUILTY NO CONTEST to the following (Circle Vehicle Code sections): 14601.1 14601.2 14601.5 14601 29. If applicable - I freely and voluntarily admit the other conviction(s) that I listed on this form. I understand that this admission will increase the penalties which are imposed on me. 30. I understand that I have the right to a delay of from 6 hours to 5 days prior to being sentenced for a misdemeanor. I give up this right and agree to be sentenced at this time. 31. If applicable - I understand that I have the right to enter my plea before, and to be sentenced by, a judge. I give up this right and agree to enter my plea before, and to be sentenced by another Santa Cruz Superior Court Judge 28. 29. 30. 31. **DEFENDANT S SIGNATURE: DATE: Page 4 of 5

ATTORNEY S STATEMENT I am the attorney of record for the defendant. I have reviewed the form and any addenda with my client. I have explained each of the defendant s rights to the defendant and answered all of the defendant s questions with regard to this plea. I have also discussed the facts of the defendant s case with the defendant, and explained the consequences of this plea, the elements of the offense(s), and the possible defenses. I concur in this plea and in the defendant s decision to their constitutional rights. SIGNATURE OF DEFENDANT S ATTORNEY DATE INTERPRETER S STATEMENT (if applicable) I, having been sworn or having a written oath on file, certify that I truly translated this form to the defendant in the language indicated below. The defendant stated that they understood the contents of the form, and then initialed and signed the form. Language: Spanish Other (specify): COURT INTERPRETER S SIGNATURE TYPE OR PRINT NAME DATE COURT S FINDINGS AND ORDER The Court, having reviewed this form and any addenda, and having questioned the defendant concerning the defendant s constitutional rights and the defendant s admission of other conviction(s) and probation violation(s), if any, finds that the defendant has expressly, knowingly, understandingly and intelligently waived their constitutional rights. The Court finds that the defendant s plea(s) and admission(s) are freely and voluntarily made with an understanding of the nature and consequences thereof, and that there is a factual basis for the plea(s). The Court accepts the defendant s plea(s), the defendant s admission of the other conviction(s) and probation violation(s), if any, and orders this form filed and incorporated in the docket by reference as though fully set forth therein. Judge of the Superior Court DATE Page 5 of 5