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UNITED STATES DISTRICT COURT DISTRICT OF MINNESOTA Criminal No. __-________ UNITED STATES OF AMERICA, Plaintiff, v. ) ) ) ) ) ) ) ) )

Defendant. ________________

STATEMENT OF FACTS IN SUPPORT OF EXCLUSION OF TIME UNDER SPEEDY TRIAL ACT [OPTIONAL FORM- USE AS SUPPLEMENT TO FORM MOTION]

Pursuant to 18 U.S.C. § 3161(h)(7)(A), I, _____________, the defendant in this case, agree to the following statement of facts in support of my motion to exclude time under the Speedy Trial Act. [Insert case-specific justification]. Based on the above facts, I request that the period of time from now until [insert date certain] be excluded from the time in which I would otherwise have to be brought to trial on my case. I have discussed this matter with my attorney. I voluntarily

make this request, with full knowledge of my rights under the Speedy Trial Act.

Dated:

_______________ _____________________________ Defendant Witness:

Dated:

________________________________ Attorney for defendant