Erie Cnty. C.P. FinalProposedCriminalLocalRules 11

By applying for ARD/PWOV and by signing this application I acknowledge, certify, and understand each of the following

rights and responsibilities:

A. I have been advised and I understand that I have a constitutional right to a speedy trial; that pursuant to

Pa.R. Crim. P. 600, the Commonwealth must bring my case to trial within 365 days from the date of the filing of the

Criminal Complaint charging me. If my case is not brought to trial within 365 days from the filing of the Criminal

Complaint, I understand I can ask the Court to dismiss all charges against me. Furthermore, I understand that in the

event I am incarcerated on these charges, the Commonwealth must bring my case to trial within 180 days from the

date of the filing of the Criminal Complaint, if the Commonwealth fails to do so, I can ask the Court for nominal bail.

I hereby waive (give up) all of my constitutional rights to a speedy trial as set forth from the date my

application for ARD is filed until my application is denied or am revoked from the ARD program, should I violate the

conditions the Court imposes on me. I have been advised and I understand that by signing this waiver I am waiving

(giving up) any and all rights I may have to be tried within 180th (if in jail) or 365th day following the filing of the

Criminal Complaint against me. I am signing the waiver because I understand it is to my benefit to do so and to

allow the District Attorney as much time as is reasonably necessary to evaluate my suitability for the ARD Program.

I have not been made any promises, nor have I been forced or coerced to sign this waiver.

B. I understand I have the right to be represented by an attorney on my charge(s) and also in connection with

my ARD/PWOV Application. If I cannot afford counsel, the Court will provide me free counsel through the Erie County

Public Defender’s Office.

C. It is my responsibility to notify the District Attorney’s Office, in writing, of my arrest and/or conviction for

any offense occurring after this Application is made and before it is rejected or I am accepted into the Program by the

Court. Failure to comply with this requirement is grounds for refusal of the Application and/or may be treated as a false

statement subjecting me to prosecution and/or for removal from the Program.

D. If charged with Driving Under the Influence: I understand that it is my responsibility to arrange for a CRN

evaluation. I understand that I cannot be placed in the ARD Program unless such evaluation is completed. I further

understand that I am to contact Impaired Driver Services, 1631 Sassafras Street, Erie, Pa 16502 at (814) 454-3326

between 8:00 a.m. and 4:30 p.m. to arrange an appointment.

E. I acknowledge that I have completed (or will complete prior to my ARD hearing) all

processing (e.g. Fingerprinting, etc.) required by me. I understand that failure to do so may delay my acceptance into

the program.

F. The information I have provided above is true and correct. I understand if I have provided

false information on this Application, that reason alone is sufficient to refuse this Application. In addition, I

understand that by providing false information I can be prosecuted for offenses including, but not limiting to,

perjury, false swearing and/or unsworn falsification to authorities.

DATE: DEFENDANT:

DATE: ATTY. FOR DEFENDANT:

Please Print

DATE: WITNESS*:

*When defendant has no attorney

Appendix 3

[binding.law: PDF page 18 has no text layer (a scanned page) and is not served]

Appendix 4

COMMONWEALTH OF PENNSYLVANIA: IN THE COURT OF COMMON PLEAS

: OF ERIE COUNTY, PENNSYLVANIA

v. : CRIMINAL DIVISION

: NO.:________________ OF 20_____

_____________________________________ : OTN:___________________________

APPLICATION FOR ERIE COUNTY TREATMENT COURT

Application is hereby made for disposition of this case under the Erie County Treatment Court Program. To

assist the District Attorney’s Office in evaluating the suitability of this case for the Erie County Treatment Program,

the following information is provided:

INSTRUCTIONS: Answer all questions that apply. If a question does not apply, answer it with the initials N.A.

1. Full Name of the defendant: _____________________________________________________________

2. Maiden Name of defendant; or other last names previously used: ________________________________

____________________________________________________________________________________

3. Date of Birth: ___________________ Social Security Number: ____________________________

Gender (circle one): M/F Race/Ethnicity: ___________________________________

4. Driver License Number: _____________________________ State Issued: ________________________

5. PresentAddress:______________________________________________________________________

City: ________________________ State: ____________ Zip Code: _______________________

Phone: (Home) ( ) (Cell) ( )

Email Address: ________________________________

6. Present Employment: Work Phone ( )

7. Next of Kin or Emergency Contact: Name: Phone ( )

8. Education-Schools and Highest Year attained: _______________________________________________

9. Have you served in the Military? _______ If so, which branch? _________________________

Were you honorably discharged? _________________________

Are you eligible for services through the VA? ________

Are you enrolled in services through the VA? ________

10. Do you have any other pending criminal charge(s)? If so, explain giving date, place, charges and

disposition:

____________________________________________________________________________________

____________________________________________________________________________________

11. Are you currently on supervision (probation or parole)? If so, explain whether it is county or state

supervised and the name of your probation/parole officer:

____________________________________________________________________________________

____________________________________________________________________________________