IN RE: APPROVAL OF REVISED JUVENILE DELINQUENT AND YOUTHFUL OFFENDER ORDER FORMS
2026 OK 40
Decided: 05/27/2026
SUPREME COURT OF THE STATE OF OKLAHOMA
Cite as: 2026 OK 40, __ P.3d __
IN RE: APPROVAL OF REVISED JUVENILE DELINQUENT AND YOUTHFUL OFFENDER ORDER FORMS
ORDER
At the request of the Oklahoma Court of Criminal Appeals, the Court has reviewed proposed revisions to the Juvenile Delinquent and Youthful Offender forms submitted by the Juvenile Justice Oversight and Advisory Committee. Revisions to the forms have been made in response to statutory amendments and to ensure that the forms comport with the statutory requirements of the Oklahoma Juvenile Code at 10A O.S. §§ 2-2-401 -- 2-2-404 and the Youthful Offender Act at 10A O.S. §§ 2-5-201 -- 2-5-209A.
1. The following juvenile delinquent forms are approved for use and shall supersede all prior versions:
a. The "Adjudication of Delinquent" form is hereby revised and replaced with a "Summary of Facts: Adjudication of Delinquent Petition(s)," attached as "Exhibit A."
b. The "Addendum to Summary of Facts" form is hereby revised and replaced with a "Addendum to Summary of Facts: Adjudication of Delinquent Petition(s)," attached as "Exhibit B."
2. The following youthful offender forms are approved for use and shall supersede all prior versions:
a. The "Youthful Offender Plea Paperwork" form is hereby revised to "Youthful Offender Plea of Guilty -- Summary of Facts," as attached hereto as "Exhibit C."
b. The "Judgment of Adjudication" form is hereby revised to "Judgment of Adjudication as Youthful Offender," as attached as "Exhibit D."
The Court hereby adopts the attached revised order forms effective May 26, 2026, and directs the Administrative Office of the Courts to publish the revised forms, superseding the current forms, on its Legal Forms website at OSCN.net.
DONE BY ORDER OF THE SUPREME COURT IN CONFERENCE ON THE 26TH DAY OF MAY, 2026.
/s/_______________________________________
CHIEF JUSTICE
ALL JUSTICES CONCUR
EXHIBIT A
IN THE JUVENILE DIVISION OF THE DISTRICT COURT OF
____________________________________ COUNTY, STATE OF OKLAHOMA
IN THE MATTER OF: ) Case ______________________________________________
) Number(s)
________________________________________________, ) ______________________________________________
A DELINQUENT CHILD )
______________________________________________
JUDGE _________________________________
[ ] Deferred Adjudication [ ] Adjudication [ ] Other: _________________________________________________________
Okla. Stat. tit.10A, § 2-2-404(A) Okla. Stat. tit.10A, § 2-2-402(C)
SUMMARY OF FACTS: ADJUDICATION OF DELINQUENT PETITION(S)
1. My name is: __________________________________________________________________________________________________
2. How old are you? _________________________________________ My birthday is: _________________________________
3. What grade are you in? ______________________ I go to ______________________________________________school
When I attend school, I am in: [ ] general classes [ ] advance placement classes [ ] special education classes
[ ] learning disability classes [ ] other ___________________________________________________________________
4. Do you take any medicine? YES NO If yes, what medicine do you take? ____________________________________
____________________________________________________________ Do you take it every day? YES NO
5. Is there any medicine you are supposed to be taking but are not taking? ________________________
6. Have you ever been treated by a doctor OR been placed in a hospital for your mental health? YES NO
If yes, when/where/why: _____________________________________________________________________________________
_____________________________________________________________________________________________________________
7. My lawyer's name is: ________________________________________________________________________________________
8. Child's Lawyer: Have you, your client & your client's parent/guardian/legal custodian(s) received a copy
of the petition(s)? YES NO
9. Child's Lawyer: Do you have any reason to believe your client IS NOT currently COMPETENT? YES NO
"Competency refers to a child's ability to understand the nature and objectives of a proceeding against the child
or to assist in the child's defense. A child is incompetent if, due to developmental disability, developmental
immaturity, intellectual disability, or mental illness the child is presently incapable of understanding the
nature and objective of proceedings against the child or of assisting in the child's defense."
Okla. Stat. tit. 10A, § 2-2-401(1)
10. Child's Lawyer: Does the State move to dismiss or amend any charges? YES NO
If yes, please list the amendments or changes: ________________________________________________________
_______________________________________________________________________________________________________
11. I understand that I am now entering a plea to the following delinquent charges. YES NO
Charge: Level of charge Plea Statutory Reference: Class Letter and Number
1.__________________________________ [ ] Felony [ ] Stipulation tit. _____, § __________ ________________
[ ] Misdemeanor [ ] No Contest
2.__________________________________ [ ] Felony [ ] Stipulation tit. _____, § __________ ________________
[ ] Misdemeanor [ ] No Contest
3.__________________________________ [ ] Felony [ ] Stipulation tit. _____, § __________ ________________
[ ] Misdemeanor [ ] No Contest
4.__________________________________ [ ] Felony [ ] Stipulation tit. _____, § __________ ________________
[ ] Misdemeanor [ ] No Contest
5.__________________________________ [ ] Felony [ ] Stipulation tit. _____, § __________ ________________
(Attach Addendum if needed for additional charges) [ ] Misdemeanor [ ] No Contest
12. My lawyer and I have talked about the facts and the evidence in my case(s). I understand that I do not
have to stipulate or plead no contest to the charge(s) alleged in this/these case(s) and that I have all
the following constitutional rights:
A. I have a right to have a lawyer defend me. If my parent(s), guardian(s), or legal custodian(s) cannot
afford to hire a lawyer the court will provide one for me;
B. I understand the law presumes that I did not commit the charge(s) alleged in the petition(s) and that
I am not delinquent;
C. I have the right to remain silent and not testify. If I remain silent, the fact that I remained
silent cannot be used against me;
D. I have the right to see and hear all witnesses called to testify against me, and my lawyer can ask
them questions for me;
E. I have the right to have my witnesses ordered to come to court, testify for me, and to present any
defense I have to the charge(s);
F. The prosecutor is required to prove that I committed the charge(s) in the petition(s) beyond a
reasonable doubt;
G. I have the right to a jury trial before six (6) people who will determine whether I committed the
charge(s) alleged in the petition(s). The jury will decide if I am delinquent or not delinquent and
all six (6) jurors must agree on the decision or I will be found not delinquent; and,
H. If I don’t want to have a jury trial, I can have a trial decided by the judge (bench trial) if my
parent(s)/guardian(s), or legal custodian(s) and the prosecutor agrees, the case would be tried
before the Judge who would decide if I am delinquent or not delinquent and if I am found delinquent
the Judge will determine the appropriate disposition.
I UNDERSTAND EACH OF THESE RIGHTS AND I UNDERSTAND THAT BY ENTERING A PLEA IN THIS/THESE
CASE(S) I AM GIVING UP ALL THE ABOVE RIGHTS. YES NO
13. I understand if I “stipulate” to the charges(s) listed above that I am admitting I did the act(s). I
understand if I plead “no contest”, I am not admitting I did the act(s) but I am agreeing to the State’s
offer of proof and agreeing to give up my right to a trial. YES NO
14. I understand if the judge accepts my stipulation(s), or my no contest plea(s), I will be found to be a
delinquent child and will be a Ward of the Court. YES NO
15. I understand that the judge will hold a dispositional hearing after I enter my plea. This hearing will
decide where I will be placed while I am a ward of the court. The judge will have the following choices,
and I understand that the judge can keep me on probation, or in custody, until my 19th birthday:
• Placement in the community with an approved parent(s), guardian(s), and/or legal custodian(s) on
probation;
• Placement in a private institution or group home; or
• Placement in the custody of the Office of Juvenile Affairs. YES NO
16. I understand that the judge can order my parent(s)/guardian(s)/legal custodian(s) and/or me to pay court
costs, fines, probation fees, programs fees, drug testing fees, and/or restitution for the damages I
caused. YES NO
17. I understand that the judge can order my parent(s)/guardian(s)/legal custodian(s) and/or me to attend
counseling or treatment programs, complete community service, complete drug testing, or other
requirements as ordered by the judge. YES NO
18. Do you believe your lawyer has helped you and are you satisfied with his/her help? YES NO
19. Do you want to stipulate or enter a no content plea to the charges(s)? YES NO
20. If the court accepts your plea to the charge(s), is there a plea agreement? YES NO
If yes, what is the plea agreement: _________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
(Attach Addendum if needed for additional description of the plea agreement)
I understand that the Court is not required to accept a plea agreement or recommendation, and if the Court
does not accept the plea agreement, I have the right to withdraw my stipulation or plea of no
contest? YES NO
21. State the factual basis for your plea: ________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
__________________________________________________________________ Initial: ____________________
22. [ ] My lawyer wrote the above statement. It is a true description of what I did, and I adopt it as my
own for the purpose of this plea. (Attach Addendum if additional space is needed)
23. I AM STIPULATING/PLEADING NO CONTEST to the charges because I want to and not because someone
(parent(s), guardian(s), legal custodian(s) lawyer or anyone else) is threatening or forcing me. There
have been no promises made to me other than the agreements made between me, my lawyer and the
prosecutor, which are contained above in question number 20 in this form. Initial: ____________________
24. I UNDERSTAND that I have the right to appeal my plea as a delinquent to the Oklahoma Court of Criminal
Appeals and that if I wish to do this, I must tell my LAWYER I want to appeal within the next 10 days.
If I do not tell my lawyer, I wish to appeal within 10 days what happened today is final.
Initial: ____________________
25. I UNDERSTAND that an adjudication for any act that would be considered a felony if it were committed by
an adult will legally prevent me from possessing a firearm or imitation firearm or from knowingly driving
or being in a vehicle or a house where a firearm or imitation firearm is present for a period of 10
years from today (Okla. Stat. tit. 21, § 1283). A conviction, as an adult, for possession of a firearm
after former adjudication can result in imprisonment in the state penitentiary for 1 to 10 years.
Initial: ____________________
26. I understand that if I am not a United States citizen, entering a plea to the act(s) could affect my
immigration status. I have talked to my lawyer about my immigration status and understand that entering
a plea today could mean I could be deported, denied naturalization or excluded from admission to the
United States. I understand that the laws regarding my immigration status are the laws of the United
States and not the laws of the State of Oklahoma. I understand my lawyer in this case does not represent
me in any immigration case and that any specific questions about immigration should be discussed with an
immigration lawyer BEFORE ENTERING MY PLEA. I ALSO UNDERSTAND THAT IMMIGRATION, INCLUDING DEPORTATION,
IS A SEPARATE PROCEEDING GOVERNED BY THE LAWS OF THE UNITED STATES. I understand that no one, including
my lawyer, the prosecutor or the judge, can tell me how my plea will affect my immigration status now or
in the future. Initial: ____________________
DECLARATION OF THE CHILD
I have read, or had read to me, this form and my lawyer has gone over this form with me and explained what
everything means and answered all my questions. I understand the rights I am giving up; I know what could
happen because of my plea, and I have decided to enter this plea of my own free will and I am asking the
Court to accept my plea and make the findings that are in my best interest.
_________________________________________________ ______________________________________
Child (Signature) DATE
_________________________________________________
(Type or Print Name)
DECLARATION OF PARENT(S)/GUARDIAN(S)/LEGAL CUSTODIAN(S)
I/WE, the parent(s)/guardian(s)/legal custodian(s) of the child have read and reviewed this form and the
answers contained in it are true and correct statements. I/We understand that it is my/our responsibility to
participate actively in the services provided and to assist the child in the completion of those services. I/We
also understand that we are also responsible, along with the child, for the fines, fees, restitution, and costs
assessed in this case. I/We understand that if we fail to follow the court orders in this case that we could
be subject to contempt proceedings.
_________________________________________________ ______________________________________
Parent/Guardian (Signatures) DATE
_________________________________________________ ______________________________________
Parent/Guardian (Signatures) DATE
DECLARATION OF INTERPRETER
I have interpreted in this case for the: [ ] Child [ ] Parent(s)/Guardian(s)/Legal Custodian(s) [ ] Both
The primary language of the person(s) I interpreted for is: [ ] Spanish [ ] Other: ___________________________
I certify I interpreted this form for the child/parent(s)/guardian(s)/legal custodian(s) in their primary language
to the best of my ability.
Level of Courtroom Interpreter Credentials: [ ] Certified Interpreter ________________ [ ] Registered Interpreter
________________________________/_________________ _____________________________________________
Interpreter (Signature) DATE (Type or Print Name)
DECLARATION OF DEFENSE COUNSEL
I, the undersigned lawyer for the child, have assisted my client in filling out this form. I have explained
and discussed with my client their rights, the facts of his/her case, the possible defenses, and the consequences
of his/her decision to enter this plea and I believe the child understands the nature, purpose, and consequences
of this proceeding.
_________________________________________________ _____________________________________________
Defense Lawyer OBA #
_________________________________________________ _____________________________________________
(Type or Print Name) DATE
DECLARATION OF PROSECUTOR
I, the undersigned attorney for the State, have reviewed this form. The explanation of the plea agreement
(if any) contained in question 20 correctly sets forth the agreement between the State and the child. The offer
of proof for the no contest plea: _________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________ _____________________________________________
Assistant District Attorney OBA #
_________________________________________________ _____________________________________________
(Type or Print Name) DATE
FINDINGS AND ORDERS
THE COURT ADDRESSED THE CHILD DIRECTLY IN COURT AND FINDS AS FOLLOWS:
A. The child has been sworn and responded to the questions under oath.
B. The child has been fully informed of his/her constitutional rights and the consequences of his/her plea(s)
in this case and he/she understands them.
C. The child’s [ ] stipulation(s) [ ] plea(s) of no contest is/are knowing and voluntarily entered and accepted
by the Court.
D. The child is competent for purposes of this hearing.
E. A factual basis exists for the plea(s).
F. The child comes within the purview of the Oklahoma Juvenile Code.
G. The child is found to be delinquent and is made a ward of the Court.
THE COURT FURTHER FINDS:
A. The parent(s)/guardian(s) of the child appeared in court and were fully informed of the requirements and
responsibilities they have in assisting their child or ward in completing the terms of this plan.
B. This explanation included their responsibility to actively participate in the services provided and the
possible consequences of their failing to follow the Court's orders.
IT IS FURTHER ORDERED that the case is set for a disposition hearing [ ]instanter (immediately) or [ ]on
the _____ day of __________________________, 20_____, at __________ A.M./P.M.
DATED this ________ day of __________________, 20_____.
___________________________________________
JUDGE OF THE DISTRICT COURT
EXHIBIT B
IN THE JUVENILE DIVISION OF THE DISTRICT COURT OF
____________________________________ COUNTY, STATE OF OKLAHOMA
IN THE MATTER OF: ) Case ______________________________________________
) Number(s)
________________________________________________, ) ______________________________________________
A DELINQUENT CHILD )
______________________________________________
JUDGE _________________________________
[ ] Deferred Adjudication [ ] Adjudication [ ] Other: _________________________________________________________
Okla. Stat. tit.10A, § 2-2-404(A) Okla. Stat. tit.10A, § 2-2-402(C)
ADDENDUM TO SUMMARY OF FACTS: ADJUDICATION OF DELINQUENT PETITION(S)
Please use this Addendum to answer overflow information for Questions 11, 19, and 20 or if additional space is
needed to answer any other question(s).
Question #11
Charge: Level of charge Plea Statutory Reference: Class Letter and Number
6.__________________________________ [ ] Felony [ ] Stipulation tit. _____, § __________ ________________
[ ] Misdemeanor [ ] No Contest
7.__________________________________ [ ] Felony [ ] Stipulation tit. _____, § __________ ________________
[ ] Misdemeanor [ ] No Contest
8.__________________________________ [ ] Felony [ ] Stipulation tit. _____, § __________ ________________
[ ] Misdemeanor [ ] No Contest
9.__________________________________ [ ] Felony [ ] Stipulation tit. _____, § __________ ________________
[ ] Misdemeanor [ ] No Contest
10._________________________________ [ ] Felony [ ] Stipulation tit. _____, § __________ ________________
[ ] Misdemeanor [ ] No Contest
11._________________________________ [ ] Felony [ ] Stipulation tit. _____, § __________ ________________
[ ] Misdemeanor [ ] No Contest
12._________________________________ [ ] Felony [ ] Stipulation tit. _____, § __________ ________________
(Attach Addendum if needed for additional charges) [ ] Misdemeanor [ ] No Contest
Question #19
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
Question #20
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
__________________________________________________________________ Initial: ____________________
[ ] My Lawyer wrote the above statement. It is a true description of what I did and I adopt it as my own for
the purpose of this plea.
Other Questions: ________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________ ______________________________________
Child Date
_________________________________________________ _____________________________________________
Parent/Guardian Parent/Guardian
_________________________________________________ _____________________________________________
Lawyer for the child Assistant District Attorney
EXHIBIT C
IN THE DISTRICT COURT OF ______________________ COUNTY
STATE OF OKLAHOMA
STATE OF OKLAHOMA, )
Plaintiff, )
)
v. ) Case No. ______________________________
)
____________________________________________, ) [NOTE: The trial judge shall ensure the
Defendant. ) defendant is sworn either prior to
) completing the Summary of Facts or prior
Last four digits of SS#_____________________ ) to inquiry by the Court on the Plea. If
Last four digits of D.L.#____________ State _____ ) the defendant is entering a nolo
Year of Birth _______ Place of Birth ____________ ) contendere, or other type guilty plea,
Oklahoma DOC# ___________________________________ ) correct by pen change where term
) “guilty” used.]
________________________________________________ )
)
________________________________________________ )
)
________________________________________________ )
(Home Address)
YOUTHFUL OFFENDER PLEA OF GUILTY – SUMMARY OF FACTS
PART A: Findings of Fact, Acceptance of Plea
CIRCLE
1. Is the name just read to you your true name? Yes No
If no, what is your correct name? ________________________________________________________
I have also been known by the name(s): ___________________________________________________
__________________________________________________________________________________________.
2. My lawyer’s name is ______________________________________________________________________.
3. (a) Do you wish to have a record made of these proceedings by a Court Reporter? Yes No
(b) Do you wish to waive this right? Yes No
4. Age:___________ Grade completed in school:______________________________________________
5. Can you read and understand this form? (If the answer above is no, Addendum A is to Yes No
be completed and attached.)
6. Are you currently taking any medications or substances which affect your ability to Yes No
understand these proceedings?
7. Have you been prescribed any medication that you should be taking, but you are not Yes No
taking?
If so, what kind and for what purpose? ____________________________________________________
___________________________________________________________________________________________.
8. Have you ever been treated by a doctor or health professional for mental illness or Yes No
confined in a hospital for mental illness?
If yes, list the doctor or health professional, place, and when occurred:
___________________________________________________________________________________
___________________________________________________________________________________
9. Counselor, do you have any reason to believe your client is not mentally competent Yes No
to appreciate and understand the nature, purpose and consequences of these
proceedings and to assist you in presenting any defense the client may have to the
charge(s)?
10. Counselor, do you have any reason to believe that your client was not mentally Yes No
competent to appreciate and understand the nature, purpose and consequences of their
actions at the time they were committed, and out of which the charges(s) contained
in the Information arose?
11. Do you understand the nature and consequences of this proceeding? Yes No
12. Have you received a copy of the Information and read the allegations? Yes No
13. Does the State move to dismiss or amend any case(s) or count(s) in the Information Yes No
or on Page 2 of the Information? If so, set forth the cases/counts dismissed or
amended: ____________________________
___________________________________________________________________________________
___________________________________________________________________________________
14. A. Do you understand you are now entering a plea to the following charges:
Crime Statutory Reference Class Letter and
Number
(1) ____________________________________ _______O.S._______ ________________ Yes No
(2) ____________________________________ _______O.S._______ ________________ Yes No
(3) ____________________________________ _______O.S._______ ________________ Yes No
(4) ____________________________________ _______O.S._______ ________________ Yes No
(5) ____________________________________ _______O.S._______ ________________ Yes No
(6) ____________________________________ _______O.S._______ ________________ Yes No
For additional charges: List any additional charges on a separate sheet and label as
PLEA OF GUILTY ADDENDUM B.
15. CHECK ALL APPLICABLE SECTIONS LISTED BELOW.
(Note: the applicable sections will ONLY APPLY if the youthful offender is sentenced
to or transferred (bridged) into the custody or supervision of the Department of
Corrections):
_____ (Check if applicable) Do you understand you are subject to the Delayed Yes No
Sentencing Program for Young Adults and what that sentencing program involves?
_____ (Check if applicable) Do you understand that a conviction on a plea of guilty Yes No
to the offense(s) of
______________________________________________________________________ will subject
you to mandatory compliance with the Oklahoma Sex Offender Registration Act?
_____ (Check if applicable) Do you understand that any person sentenced to Yes No
imprisonment for two (2) years or more for the offense(s) of
________________________________________________________, involving sexual abuse,
sexual exploitation, or illegal sexual conduct, shall be required to serve a term of
post-imprisonment supervision for at least three (3) years under conditions
determined by the Court in addition to the actual term of imprisonment. There will
be no post-imprisonment supervision for a sentence of life or life without the
possibility of parole for offenses involving sexual abuse, sexual exploitation, or
illegal sexual conduct.
_____ (Check if applicable) Do you understand that a conviction on a plea of guilty Yes No
to the offense(s) of __________________________________________________________will
subject you to mandatory compliance with the Oklahoma Methamphetamine Offender
Registry Act?
_____ (Check if applicable) Do you understand that a conviction on a plea of guilty Yes No
to the offense of _________________________________________________________________
will subject you to mandatory compliance with the Mary Rippy Violent Crime Offenders
Registration Act?
16. Applicable to Sentencing Modernization Act Class C/D crimes, with exceptions:
Do you understand that you will be required to serve a minimum percent of the Yes No
sentence imposed before release from custody, including release to electronic
monitoring pursuant to the Sentencing Modernization Act in the following Count(s):
___________________________________________________________________________________
___________________________________________________________________________________
Applicable to 21 O.S. § 13.1 crimes:
Do you understand that you will be required to serve a minimum of 85% of the Yes No
sentence of imprisonment imposed before being eligible for parole consideration and
are not eligible for earned or other type of credits which will have the effect of
reducing the length of sentence to less than 85% of the sentence imposed in the
following Count(s): ______________________________________________________________
__________________________________________________________________________________?
Applicable to statute specific percent requirement crimes not covered above:
Do you understand that you will be required to serve a minimum of ______% of the Yes No
sentence of imprisonment imposed or received prior to becoming eligible for state
correctional earned credits toward completion of your sentence or eligibility for
parole in the following Count(s):
__________________________________________________________________________________
__________________________________________________________________________________?
17. Do you understand that if you are sentenced or transferred (bridged) into the Yes No
custody or supervision of the Department of Corrections and become a convicted felon
that this could enhance punishment in any future crime committed by you?
18. Do you understand that being sentenced or transferred (bridged) into the custody or Yes No
supervision or the Department of Corrections could affect other of your personal
rights including: your right to vote, your ability to obtain a driver's license,
your ability to obtain certain professional licenses required by the State, your
ability to secure student loans to attend college and your ability to obtain U.S.
citizenship if you are not already a citizen?
19. Do you understand it is unlawful for you to have in your possession or under your Yes No
immediate control, or have in any vehicle you are driving, or at your residence, any
pistol, imitation or homemade pistol, altered air or toy pistol, machine gun,
sawed-off shotgun or rifle, or any other dangerous or deadly firearm within ten (10)
years after your adjudication? Okla. Stat. tit. 21 § 1283(D).
20. Do you understand that upon your release from any facility where you were placed by Yes No
the Office of Juvenile Affairs, you will be subject to supervised community
placement rules?
21. Do you understand your plea to the charge(s) may carry a risk of adverse immigration Yes No
consequences if you are a non-citizen?
22. Do you understand the range of punishment for the crime(s) is/are: (List in same
order as in No. 14) [Mark percentage as N/A if not applicable.]
(1) Minimum of __________ to a maximum of ______________ at ______ % and/or a fine of Yes No
$_________
(2) Minimum of __________ to a maximum of ______________ at ______ % and/or a fine of Yes No
$_________
(3) Minimum of __________ to a maximum of ______________ at ______ % and/or a fine of Yes No
$_________
(4) Minimum of __________ to a maximum of ______________ at ______ % and/or a fine of Yes No
$_________
(5) Minimum of __________ to a maximum of ______________ at ______ % and/or a fine of Yes No
$_________
(6) Minimum of __________ to a maximum of ______________ at ______ % and/or a fine of Yes No
$_________
For additional charges: List any additional punishments on a separate sheet, with
additional crimes and labeled as PLEA OF GUILTY ADDENDUM B.
23. Read the following statements: You have the right to a speedy trial before a jury
for the determination of whether you are guilty or not guilty and if you request, to
determine sentence. [If pleading to capital murder, advise of procedure in 21 O.S. §
701.10(B)]. At the trial:
(1) You have the right to have a lawyer represent you, either one you hire yourself or
if you are indigent a court appointed attorney.
(2) You are presumed to be innocent of the charges.
(3) You may remain silent or, if you choose, you may testify on your own behalf.
(4) You have the right to see and hear all witnesses called to testify against you and
the right to cross-examine them.
(5) You may have your witnesses ordered to appear in court to testify and present
evidence of any defense you have to these charges.
(6) The state is required to prove your guilt beyond a reasonable doubt.
(7) The verdict of guilty or not guilty decided by a jury must be unanimous.
However, you can waive a jury trial and, if all parties agree, the case could be
tried by a Judge alone who would decide if you were guilty or not guilty and if
guilty, the appropriate punishment.
24. Do you understand each of these rights? Yes No
25. Do you understand by entering a plea of guilty you give up these rights? Yes No
26. Do you understand that if you are sentenced or transferred (bridged) to the Yes No
Department of Corrections that the range of punishment in any future case committed
by you could be increased?
27. Have you talked over the charge(s) with your lawyer, advised him/her regarding any Yes No
defense you may have to the charges and had his/her advice?
28. Do you believe your lawyer has effectively assisted you in this case and are you Yes No
satisfied with his/her advice?
29. Do you wish to change your plea of not guilty to guilty and give up your right to a Yes No
jury trial and all other previously explained constitutional rights?
30. Is there a plea agreement? Yes No
What is your understanding of the plea agreement? _________________________________
___________________________________________________________________________________
___________________________________________________________________________________
31. Do you understand the Court is not bound by any agreement or recommendation and if Yes No
the Court does not accept the plea agreement, you have the right to withdraw your
plea of guilty?
32. Do you understand that if there is no plea agreement the Court can sentence you Yes No
within the range of punishment stated in Question 22?
33. What (is)/(are) your plea(s) to the charge(s) (and to each one of them)? __________
___________________________________________________________________________________
34. Did you commit the acts as charged in the Information? Yes No
35. State the factual basis for your plea(s) (attach additional pages as needed, labeled
as ADDENDUM C):
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
36. Have you been forced, abused, mistreated, or promised anything by anyone to have you Yes No
enter your plea(s)?
37. Do you plead guilty of your own free will and without any coercion or compulsion of Yes No
any kind?
38. Do you have any additional statements to make to the Court? Yes No
39. Is there any legal reason you should not be adjudicated as a Youthful Offender now? Yes No
I acknowledge, by my signature below, that my attorney and I have specifically reviewed the terms and
conditions contained in Question No. 30, and that I understand the terms of the plea agreement into
which the Court, the State and I are entering today. In addition, I understand the possible
consequences if I am transferred (bridged) into the custody or supervision of the Department of
Corrections based upon a finding being made by the Court by clear and convincing evidence that I
committed one of more of the acts defined in Okla. Stat. tit. l0A § 2-5-210A(A)(2)(a-g).
___________________________________
DEFENDANT
HAVING BEEN SWORN, I, the Defendant whose signature appears below, make the following statements under oath:
(1) CHECK ONE
______(a) I have read, understand and completed this form.
______(b) My attorney completed this form and we have gone over the form and I understand
its contents AND I agree with the answers.
______(c) The Court provided an interpreter or someone to read the form to me and I understand
its contents and agree with the answers. See Addendum “A”.
______(d) The Court completed this form for me and inserted my answers to the questions.
(2) The answers are true and correct.
(3) I understand that I may be prosecuted for perjury if I have made false statements to this
Court.
___________________________________
DEFENDANT
Acknowledged this ______ day of ___________________, 20_______.
____________________________________
Notary Public/Deputy Court Clerk/Judge
40. I, the undersigned attorney for the Defendant, believe the Defendant understands the nature,
purpose and consequence of this proceeding. (S)He is able to assist me in formulating any
defense to the charge(s). I am satisfied that the Defendant’s waivers and plea(s) of guilty
are voluntarily given and he/she has been informed of all legal and constitutional rights.
____________________________________
ATTORNEY FOR DEFENDANT
41. The sentence recommendation in Question 30 is correctly stated.
42. Offer of Proof (Nolo contendere plea): ______________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
____________________________________
ASSISTANT DISTRICT ATTORNEY
THE COURT FINDS AS FOLLOWS:
43. The Defendant was sworn and responded to questions under oath.
The Defendant understands the nature, purpose and consequence of this proceeding.
The Defendant’s plea(s) of ________________________ is/are knowingly and voluntarily entered
and accepted by the Court.
The Defendant is competent for the purpose of this hearing.
A factual basis exists for the plea(s).
The Defendant is guilty as charged.
The Defendant is committed as a youthful offender to the:
_____ Custody _____ Supervision
of the Office of Juvenile Affairs for ______________ Years/Months.
The Office of Juvenile Affairs written rehabilitation plan shall be prepared and filed with
the Court and provided to the attorneys for the Defendant and the State, within thirty (30)
days of receiving notification of this placement.
The Defendant is ordered to pay instanter:
Court Costs in the amount of $_____________________.
VCA in the amount of $___________________.
THIS CASE IS SET FOR HEARING BEFORE JUDGE ___________________ ON THE _______ DAY OF
____________________, 20_____ at _______________.M. FOR A REVIEW OF THE PLACEMENT OF THE
YOUTHFUL OFFENDER AND THE ADOPTION OF THE WRITTEN REHABILITATION PLAN.
BY OUR SIGNATURES BELOW, WE STATE THAT WE HAVE READ THE YOUTHFUL OFFENDER PLEA OF
GUILTY - SUMMARY OF FACTS AND UNDERSTAND THE CONTENT AND ACKNOWLEDGE THAT IT IS TRUE
AND CORRECT.
___________________________________________ ________________________________________________
DEFENDANT (PRINTED) DEFENDANT (SIGNATURE)
___________________________________________ ________________________________________________
ATTORNEY FOR THE DEFENDANT (PRINTED) ATTORNEY FOR THE DEFENDANT (SIGNATURE)
___________________________________________ ________________________________________________
ATTORNEY FOR THE STATE (PRINTED) ATTORNEY FOR THE STATE (SIGNATURE)
DONE IN OPEN COURT this ______ day of _______________________, 20_____.
___________________________________________ ________________________________________________
COURT REPORTER PRESENT JUDGE OF THE DISTRICT COURT
___________________________________________ ________________________________________________
DEPUTY COURT CLERK NAME OF JUDGE TYPED OR PRINTED
BASED ON THE ABOVE PLEA AGREEMENT ADJUDICATING THE DEFENDANT AS A YOUTHFUL
OFFENDER, THE YOUTHFUL OFFENDER IS NOTIFIED AS FOLLOWS:
A. The defendant has been adjudicated as a youthful offender and upon his or her successful completion of the
rehabilitation plan this case shall be dismissed, and the defendant may apply for expungement pursuant to the
provisions of Okla. Stat. tit. l0A § 2-5-210A(D)(1-6);
B. In addition, the youthful offender understands that he/she may be transferred (bridged) to the Department of
Corrections if the Court finds by clear and convincing evidence that the youthful offender has committed one of
more of the following acts defined in Okla. Stat. tit. l0A § 2-5-210A(A)(2):
(a) failed to make substantial progress towards completing the treatment plan which the youthful offender
is expected to have achieved,
(b) established a pattern of disruptive behavior which is not conducive to the established policies and
procedures of the program or facility or engaged in other types of behavior which has endangered the
life or health of other residents or staff of the facility,
(c) caused disruption in the facility, smuggled contraband into the facility, or participated or assisted others
in smuggling contraband into the facility,
(d) committed battery or assault and battery on an OJA employee or contractor of a juvenile facility,
(e) committed battery, assault and battery, or endangered the life or health of another person,
(f) committed a felony while in the custody or supervision of OJA as demonstrated by:
(1) the entry of a plea of guilty or nolo contendere,
(2) an adjudication, or a judgment and sentence following a verdict of guilty, or
(3) clear and convincing evidence, or
(g) left a facility in which the youthful offender was being held without permission.
NOTICE OF RIGHT TO APPEAL
To appeal from this plea of guilty and adjudication as a youthful offender you must file in the District Court
Clerk's Office a written Application to Withdraw your Plea of Guilty as a Youthful Offender within ten (10)
days from today's date. You must set forth in detail why you are requesting to withdraw your plea. The trial
court must hold a hearing and rule upon your Application within thirty (30) days from the date it is filed.
If the trial court denies your Application, you have the right to ask the Oklahoma Court of Criminal Appeals
to review the District Court's denial by filing a Petition for Writ of Certiorari within ninety (90) days
from the date of the denial. Within ten (10) days from the date the Application to Withdraw Plea of Guilty
is denied, Notice of Intent to Appeal and Designation of Record must be filed pursuant to Oklahoma Court
of Criminal Appeals Rule 4.2(D). If you are indigent, you have the right to be represented on appeal by a
court appointed attorney.
Do you understand each of these rights to appeal? Yes No
Have you fully understood the questions that have been asked? Yes No
Have your answers been freely and voluntarily given? Yes No
I ACKNOWLEDGE UNDERSTANDING OF MY RIGHTS AND THE YOUTHFUL OFFENDER ADJUDICATION AND SENTENCE IMPOSED.
___________________________________________
DEFENDANT
I, THE UNDERSIGNED ATTORNEY, HAVE ADVISED THE DEFENDANT REGARDING HIS/HER APPELLATE RIGHTS AS A YOUTHFUL OFFENDER.
___________________________________________
ATTORNEY FOR THE DEFENDANT
DONE IN OPEN COURT ON THIS ______ DAY OF ________________20 _____.
_____________________________________________ ___________________________________________
Court Reporter Present JUDGE OF THE DISTRICT COURT
______________________________________________ ____________________________________________
Deputy Court Clerk NAME OF JUDGE TYPED OR PRINTED
YOUTHFUL OFFENDER PLEA OF GUILTY—SUMMARY OF FACTS
ADDENDUM “A”
CERTIFICATE OF DEFENSE COUNSEL
As the attorney for the defendant, _____________________________________, I certify that:
1. The Defendant has stated to me that he/she is (able/unable) to read and understand the attached form, and I have:
(check appropriate option)
____ determined the Defendant is able to understand the English language.
____ determined the Defendant is unable to understand the English language and obtained
_______________________ to interpret.
2. I have read and fully explained to the Defendant the allegations contained in the Information in this case.
3. I have read and fully explained to the Defendant all the questions in the Youthful Offender Plea of
Guilty—Summary of Facts and the answers to the questions set out in the Summary of Facts are the Defendant's
answers.
4. To the best of my knowledge and belief the statements and declaration made by the Defendant are accurate
and true and have been freely and voluntarily made.
Dated this _____ day of ____________________, 20_____.
____________________________________
ATTORNEY FOR THE DEFENDANT
EXHIBIT D
IN THE DISTRICT COURT OF _________________________ COUNTY
THE STATE OF OKLAHOMA
THE STATE OF OKLAHOMA, )
)
Plaintiff, )
)
vs. ) Case No. CF/YO-20_____-______
) D.O.B.: _______________________________
_______________________________, ) SS# (last 4): _________________________
Defendant. ) Year of birth: ______ Place of birth: _________
JUDGMENT OF ADJUDICATION AS A YOUTHFUL OFFENDER
NOW, ON THIS ____ DAY OF _______________, 20_____ this matter comes on for sentencing of
the Defendant as a youthful offender. The Youthful Offender, ____________________, appears personally,
and by and through his/her attorney of record, ______________________, and the State appears personally,
by and through, ____________________, Assistant District Attorney.
The Defendant, appears before this court having been adjudicated as a youthful offender on the _____ day
of ________________, 20_____, following:
[ ] the entry of a plea of guilty [ ] the entry of a plea of Nolo Contendre
[ ] having been adjudicated by a jury at trial [ ] having been adjudicated by the court after waiving
their right to a jury trial
[ ] other: ____________________________________________________________________ to the crime(s) of:
Count Crime Statutory Reference Class/Number Date of Offense
_____ ___________________________________ ____ O.S. ______ ___________ ___________________
_____ ___________________________________ ____ O.S. ______ ___________ ___________________
_____ ___________________________________ ____ O.S. ______ ___________ ___________________
_____ ___________________________________ ____ O.S. ______ ___________ ___________________
(If necessary, attach an additional sheet for additional counts)
and was sentenced as a youthful offender as follows:
Count Sentenced to a term of:
_____ __________________________________________________________________________________________________
_____ __________________________________________________________________________________________________
_____ __________________________________________________________________________________________________
_____ __________________________________________________________________________________________________
(If necessary, attach an additional sheet for additional counts)
The sentence(s) are to be served: [ ] concurrently [ ] consecutive: _______________________________________________
The Youthful Offender is ordered to pay fine(s), costs, fees, and restitution as follows:_______________________
________________________________________________________________________________________________________________
The Youthful Offender is placed in the: [ ] Custody OR [ ] Supervision of:
[ ] The Office of Juvenile Affairs or
[ ] other: _________________________________________________________________________________________________
[ ] The Office of Juvenile Affairs is ordered, pursuant to Okla. Stat. tit. 10A § 2-5-208A(E), to prepare and
file a written rehabilitation plan within thirty (30) days of receiving notification of the placement of
this youthful offender.
[ ] other: ________________________________________________________________________________________________
_________________________________________________________________________________________________________
IT IS SO ORDERED, ON THIS _____ DAY OF ____________________, 20_____.
________________________________________________
JUDGE OF THE DISTRICT COURT
Citationizer© Summary of Documents Citing This Document
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