STATE OF NORTH CAROLINA                 IN THE GENERAL COURT OF JUSTICE

COUNTY OF ________________________                                    DISTRICT COURT DIVISION

STATE OF NORTH CAROLINA

File No. __________________________

VS.

______________________________

(Attorney to complete above)

WAIVER AND PLEA

I ________________________________, of ________________ County, State of ____,

The defendant in the above captioned matter, hereby waive my right to personally appear before the District Court, in and for Henderson and/or Polk County, N.C., and authorize my attorneys from the Sheffron Law Firm acting as my attorney-in-fact, if unable to have my case dismissed to negotiate and enter a plea on my behalf as is in their/his/her professional judgment shall be in my best interest.  In making this waiver and plea, I specifically:

Defendant must answer and initial the following

Acknowledge I  (___ have ___ have not) received a PJC (prayer for judgment continued) in the previous three years from a NC      Court regarding my Driver License.

Acknowledge I  (___ have ___ have not) attended a driver education course in the previous three years.

If I attended a Driver Education course in the previous three years it was a ___ (4) hour or ___(8) hour class

Acknowledge the jurisdiction and authority of the District Court in and for the above captioned County, NC. Waive the reading of an Information and of the filing of an Information. Acknowledge that I have discussed all of my rights and options with my attorney. freely and voluntarily  enter this plea with knowledge that if my case is not dismissed I may be subject to a possible fine, costs, and in certain cases subject to completing a driver education course. Do expressly acknowledge that I have   a right to a trial and a right to examine any and all witnesses who might be called to testify against me and waive said right to trial.  I specifically understand and acknowledge no promises have been made to  me ragarding any certain outcome of this matter, agree to cooperate and follow the instructions of my attorney and have been advised to contact my local DMV and insurance co.  regarding any questions about license points and/or insurance. With knowledge of the foregoing, I reiterate my Waiver and Plea. I understand failure to comply with instructions from my attorney shall constitute a breach of contract and shall terminate the attorney -client relationship.  I understand attorney shall have no responsibility or liability  and may  cease representation should I fail to comply with my attorney's instrctions

This the _____ day of ________________,200__ __________________________________________________ Signature ___________________________________________________ Print Name ___________________________________________________ Mailing Address ___________________________________________________ City,                                                            State,                 Zip ___________________________________________________ Telephone

Sheffron Law Firm 317 N. Washington Street Hendersonville, NC 28739 Tel. (828) 698-9889 Fax (828) 698-9670