Free DUII Diversion Form 1: Uniform DUII Diversion Petition and Agreement (revised 1-1-08) - Oregon


File Size: 117.5 kB
Pages: 1
Date: December 12, 2007
File Format: PDF
State: Oregon
Category: Court Forms - State
Author: jagernc
Word Count: 443 Words, 3,899 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.ojd.state.or.us/web/OJDPublications.nsf/Files/DUII_Diversion_Form_1.pdf/$File/DUII_Diversion_Form_1.pdf

Download DUII Diversion Form 1: Uniform DUII Diversion Petition and Agreement (revised 1-1-08) ( 117.5 kB)


Preview DUII Diversion Form 1: Uniform DUII Diversion Petition and Agreement (revised 1-1-08)
DUII Diversion Form 1

UNIFORM DUII DIVERSION PETITION AND AGREEMENT
DUII diversion forms 2, 3, and 4 must be filed with this form and served on the district attorney or city attorney who filed the charge. Petitioner is to provide the information required in this box as follows (print or type): Petitioner's Name and Residence: Court where charge was filed ________________________________________________________ and petition is to be submitted: First Middle Last ________________________ ________________________________________________________ Street City State ZIP ________________________ ________________________________________________________ Court Name Mailing Address (if different) ________________________ Date of Birth: Phone #: Driver License: Court Case Number _____ /____ /_____ Month Day Year _______________ _____________ _____ Number State ________________________ Date of DUII Offense

For Court File Stamp

Petitioner's Agreement and Waiver
I, the petitioner, request that this court grant a diversion under ORS 813.200 to 813.270 in this case for the charge of driving under the influence of intoxicants (DUII). If the court allows this petition: 1) I agree to all of the items listed under the "Agreement with the Court" section of DUII Diversion Form 2 (located on the back of this form unless filed electronically) and have read and understand all of the other information in Form 2; 2) I plead guilty or no contest to the DUII charge as shown in the plea petition (DUII Diversion Form 4) submitted with this diversion petition; 3) I waive (give up) the rights listed in the plea petition; and 4) I waive my former jeopardy rights under the federal or state constitutions and ORS 131.505 to 131.525 in any future action on the charge or any other offenses based on the same criminal incident.

__________________________________ __________________________________ __________________
Petitioner's Signature Petitioner's Name (typed or printed) Date

COURT ORDER


For Court File Stamp

The court (allows) (denies) the petition for diversion. The DUII charge is alleged to have occurred on _________________, 20____. If "allowed," this court withholds entry of a judgment of conviction pending completion or termination of the diversion, and orders that: 1) The diversion period is one year beginning on ____ /____ /_____ and ending on ____ /____ /_____; 2) The petitioner must pay fees to the court for the diversion as required by statute unless waived or deferred; Fees: $__________ Due immediately, or Payment schedule: $____ per month due by the ____ day of each month beginning ____ /____ /____ 3) The petitioner (must) (need not) attend a victim impact panel approved by this court and (must) (need not) pay a participation fee to that program; Victim Impact Panel Date: __________________________________ 4) The petitioner must pay courtappointed attorney fees in an amount of $_______ on a schedule set by the clerk of the court; 5) The petitioner (must) (need not) file a motion at the end of the diversion requesting that the DUII charge be dismissed; 6) Other: ___________________________________________________________________________________________________

__________________________________ __________________________________ __________________ Name of Judge Signature of Judge Date
Form Revised on January 1, 2008