Family - Domestic Violence - Plea Form for Use in Domestic Violence Contempt Matters
This promulgates for immediate statewide implementation the newly created Domestic Violence Contempt and Related Disorderly Persons and Petty Disorderly Persons Plea Form, CN 12692, as approved by Judicial Council. This plea form is for use when the court accepts a plea in domestic violence contempt matters heard in the Superior Court, Family Division.
Questions regarding this memorandum should be directed to the Family Practice Division at 609-815-2900 ext. 55350.
Attachment: CN 12692 - FO Plea Form cc: Chief Justice Stuart Rabner
New Jersey Judiciary County Family Court Domestic Violence Contempt and Related Prosecutor
Disorderly Persons & Petty Disorderly Persons File Number Plea Form
Ind./Acc./Comp.#
Count
Nature of Offense
Degree
(If you are pleading to an indictable offense, please use the standard Criminal Plea Form - CN 10079)
Defendant's Name:
before Judge:
List the charges to which you are pleading guilty:
Statutory Maximum
Max Time Fine
Max Max Max Max Total
The potential impact of this plea is:
Yes □ No b. Doyouunderstandthatbeforethejudgecanfindyouguilty,youwillhavetotellthejudgewhat□Yes □No
Did you commit the offense(s) to which you are pleading guilty?
you did that makes you guilty of the particular offense(s)?
2.Do you understand what the charges mean?
3.Do you understand that by pleading guilty you are giving up certain rights? Among these are:
a. The right to a bench trial in which the State must prove you guilty beyond a reasonable doubt?
b. The right to remain silent?
c. The right to confront a witness against you?
d. Do you understand that by pleading guilty you are NOT waiving your right to an appeal? (1) The denial of a motion to suppress physical evidence (R. 3-5-7(d)) or
(2) The denial of acceptance into a pretrial intervention program (PTI) (R. 3:28-6(d))
e. Do you further understand that by pleading guilty you are waiving your right to appeal the denial of all other pretrial motions except the following?
4.Do you understand if you plead guilty that:
a. You will have a criminal record?
b. Unless the plea agreement provides otherwise, you could be sentenced to serve the maximum time in jail or prison, to pay the maximum fine and to pay the maximum Victims of Compensation Office Assessment Fee?
* Victims of Crime Compensation Office Assessment
□ Yes ONo
□ Yes □No □ Yes □No □ Yes □No OYes □No
D Yes DNo
□ Yes ONo □ Yes ONo
a.
1.
Form Promulgated by Directive #23-21 08/24/21, CN 12692 page 2 of4
4. c.
You must pay a minimum Victims of Crime Compensation Office Assessment Fee of $50 ($100 minimum if you are convicted of a crime of violence) for each count to which you plead guilty? (Penalty is $30 if offense occurred between January 9, 1986 and December 22, 1991 inclusive, $25 if offense occurred before January 1, 1986.) If you are pleading guilty to a domestic violence offense, you must pay a $100 Domestic Violence Surcharge.
DYes DNo D Yes DNo
D Yes DNo D Yes DNo □Yes 0No
D Yes DNo D Yes DNo
0Yes 0No DYes DNo
D Yes DNo D Yes DNo
D Yes DNo
d.If the offense occurred on or after February 1, 1993 but was before March 13, 1995, and you are being sentenced to probation or a State correctional facility, you must pay a transaction fee of up to $1 for each occasion when a payment or installment payment is made? If the offense occurred on or after March 13, 1995 and the sentence is to probation, or the sentence otherwise requires payments of financial obligations to the probation division, you must pay a transaction fee of up to $2 for each occasion when a payment or installment payment is made?
e. If the offense occurred on or after August 2, 1993 you must pay a $75 Safe Neighborhood
Services Fund assessment for each conviction?
f. If the offense occurred on or after January 5, 1994 and you are being sentenced to probation, you must pay a fee of up to $25 per month for the term of probation?
g.You will be required to provide a DNA sample and pay for the cost of testing, which could be used by law enforcement for the investigation of criminal activity?
5.Do you understand that the court could, at its discretion, impose a minimum time in jail or prison to be served before you become eligible for release, and that this period could be as long as one half of the entire sentence imposed?
6.Do you understand that if you plead guilty of a crime or offense involving domestic violence that a condition of the sentence can restrict your ability to have contact with the victim, the victim's friends, co-workers, or relatives, or an animal - owned, possessed, leased, kept, or held by either party or a minor child residing in the household?
7.Do you understand that your guilty plea can result in the court entering an order directing the possession of an animal owned, possessed, leased, kept or held by either party or a minor child residing in the household?
8.Do you understand that when you plead guilty to a crime or offense involving domestic violence, you will be prohibited from purchasing, owning, possessing, or controlling a firearm pursuant to section 6 of P.L.1979, c.179 (C.2C:39-7) and from receiving or retaining a firearms purchaser identification card or permit to purchase a handgun pursuant to N.J.S.2C:58-3 under N.J.S.A. 2C; 25-27c(l)?
9.Do you understand that a person convicted or a second or subsequent offense of domestic violence contempt must serve a mandatory minimum sentence of at least 30 days in the County Jail? N.J.S.A 2C:25-30
10. Are you currently on probation or parole?
a. Do you realize that a guilty plea can result in a violation of your probation or parole?
11. Areyoucurrentlyservingajailorprisonsentenceonanothercharge?
a. Do you understand that a guilty plea can affect your parole eligibility?
12. Doyouunderstandthatifyouhavepleadguiltyto,orhavebeenfoundguiltyonothercharges,orare currently serving a jail or prison term and the plea agreement doesn't specify otherwise, the court can require that all sentences will run consecutively (one after the other)?
"Yes" go to question 19.
"No", you must answer questions 18b-f.
If"Yes",
"No",
13. List any charges the prosecutor has agreed to recommend for dismissal:
Ind./Acc./Compl.# Count Nature of Offense and Degree
14. Specify any sentence the prosecutor has agreed to recommend:
15. Has the prosecutor agreed NOT to speak at sentencing?
16. Do you understand that you might have to pay restitution if the court finds there is a victim who has suffered a loss?
17. Do you understand that if you are a public office holder or employee, you can be required to forfeit your office of job because of your guilty plea?
DYes D Yes
D Yes D Yes
D Yes OYes
OYes □ Yes
OYes
OYes
OYes
D Yes
D Yes
DNo D No
DNo DNo
DNo □No
□No □No
□No □No
□No DNo
DNo page 3 of4
18. a.
b.
c.
d.
e. 19. a.
b.
Are you a citizen of the United States?
If
If
Do you understand that if you are not a citizen of the United States, this guilty plea can result in your removal from the United States and/or stop you from being able to legally enter or re-enter the United States?
Do you understand that you have the right to get advice from an attorney about the specific effect your guilty plea will have on your immigration status?
Have you discussed the potential immigration consequences of your plea with an attorney?
have you been advised of the possible immigration consequences and of your right to seek individualized legal advice regarding immigration consequences?
If would you like the opportunity to discuss potential immixgration consequences with an attorney?
Do you still want to plead guilty?
Do you understand that pursuant to the rules of the Interstate Compact for Adult Offender Supervision if you are living outside the State of New Jersey at the time of sentencing, or upon entry ofa guilty plea (if a guilty plea is a condition of admission to the Pretrial Intervention Program), that return to your home can be delayed pending acceptance of the transfer of your supervision by your home state?
Do you understand that pursuant to the same Interstate Compact, transfer of your supervision to another state can be denied or restricted by that state at any time after sentencing, or upon entry of a guilty plea (if a guilty plea is a condition of admission to the Pretrial Intervention Program), if that state determines you are required to register as a sex offender in that state or if New Jersey has required you to register as a sex offender?
20. Have you discussed the legal doctrine of “merger" (when a defendant commits multiple crimes
within one incident, they may end up being convicted of only one criminal conviction)with your
attorney?
Form Promulgated by Directive #23-21 08/24/21, CN 12692
Form Promulgated by Directive #23-21 08/24/21, CN 12692
