COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.COMMONWEALTH OF PENNSYLVANIA:IN THE COURT OF COMMON PLEAS :OF ERIE COUNTY, PENNSYLVANIA :Calendar No.CRIMINAL DIVISION v.::JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)NO.: OF 20 :OTN: APPLICATION FOR DISPOSITION UNDER PROGRAM OF ACCELERATED REHABILITATIVE DISPOSITION/PROBATION WITHOUT VERDICTApplication is hereby made for disposition of this case under the Accelerated Rehabilitative Disposition/Probation Without Verdict Program. To assist the District Attorney= s Office in evaluating the suitability of this case for the ARD/PWOV Program, the following information is provided: INSTRUCTIONS:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Answer all questions that apply. If a question does not apply, answer it with the initials AN.A.@THE PEOPLE OF THE STATE OF NEW YORK TO1.Full Name of the defendant: 2.Maiden Name of defendant; or other names previously used: 3.Date of Birth: Social Security Number: GREETINGS:4.Driver License Number: State Issued:5.Present Address: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,City: State: Zip Code: Phone (Home) (located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room) (Work) ()6.Previous Addresses and length of time at each (go back 10 years): Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.7.Present Employment: , one of the Justices of the8.Education-Schools and Highest Year attained: Court in Witness, Honorableday of, 20 County,9A. Have you ever been found guilty or pleaded guilty or no contest to any criminal violation of any kind in any court other than summery offenses, whether in Pennsylvania or anywhere else? If so, explain giving date, place, charge(s), and disposition:9B.(Attorney must sign above and type name below)Do you have any other pending criminal charge(s) or have you ever been placed on ARD or PWOV? If so, explain giving date, place, charges and disposition: Attorney(s) forOffice and P.O. Address9C.Telephone No.: Facsimile No.: E-Mail Address:If charged with Driving Under the Influence: Have you ever been adjudicated a delinquent or entered into a co-agreement as a juvenile after being charged with Driving Under the Influence of Alcohol? If so, explain giving details:10. Explanation of your present case, including all details (use reverse side if needed):Mobile Tel. No.:Page 1 of 2American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.11. By applying for ARD/PWOV and by signing this application I acknowledge, certify, and understand each of the following rights and responsibilities:JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)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. 1100, 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.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:I hereby waive (give up) all of my constitutional rights to a speedy trial as set forth from the date I sign this Application until I either complete the ARD Program or am revoked from it, should I violate the conditions the Court imposes on me. In the event my Application for ARD is denied, I waive (give up) all of my constitutional rights to a speedy trial as set forth from the date I sign this Application until the last scheduled day of the term o f Criminal Court next following the date of my rejection. 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 he needs 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.WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofC.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.o'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomYour failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.D.If charged with Driving Under the Influence: I understand that it is my responsibility to arran
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