Exempt from VRA Certif.
IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA AT PALMER STATE OF ALASKA Plaintiff, vs. Defendant. DOB: Trial/Adjudication date currently set ) ) ) ) ) ) ) ) ) CASE NO. 3PAAPPLICATION FOR CHANGE OF PLEA HEARING Hearing date set: Before Judge/Magistrate in Ctrm
By (Clerk/Judicial Officer)
Hearing date requested:
1. This case involves a crime victim: Yes No mail fax in person 2. I certify that I notified the prosecutor of this application by phone on (date) at a.m./p.m. 3. Is defendant in custody? Yes No If yes, where? representing myself an attorney representing the defendant. 4. In this case, I am: 5. I request a change of plea hearing and request do not request to be sentenced at the same time. 6. I will will not waive presentence report. 7. The State has has not agreed to waive presentence report. 8. I am presently charged with felony(ies) but the plea and sentencing will be to misdemeanors only. 9. Based on the plea and sentence bargain I will have served my time by . 10. Based on the plea and sentence agreement this plea hearing will resolve (all relevant case numbers listed above) Yes No 11. Terms of Agreement:
Signature of Applicant (Defendant or Attorney) Printed Name of Applicant and Attorney Bar Number Phone Number Fax Number
I certify that on a copy of this document with hearing date was sent to: District Attorney Defense Counsel/Defendant Deputy Clerk
CR-316 PALMER(8/07)(cs) APPLICATION FOR CHANGE OF PLEA HEARING