IN THE Mount Vernon MUNICIPAL COURT, Mount Vernon, OHIO

The State of Ohio
City/Village of

Plaintiff	Case No.

vs.

Defendant

NOT GUILTY PLEA

1.	I plead NOT GUILTY

2.	I waive the reading of the complaint and acknowledge receipt of a copy of the complaint.

3.	I demand a jury trial.

4.	I waive my right to a trial by a jury.

5.	I want my case tried within the time required by law.

6.	I knowingly and voluntarily waive my right to have a trial within the time required by law.

7.	I waive my right to appear at an arraignment.

8.	I waive my right to appeal my administrative license suspension.

9.	I appeal my administrative license suspension.

10.	I waive my right to have an appeal hearing on the administrative license suspension within five days and consent to a continuance of the appeal hearing until a later date.

Defendant’s Signature	Trial Counsel’s Signature

Street Address/PO Box Number	Print Name

City/State/Zip Code	Street Address/PO Box Number

Area Code/Phone Number	City/State/Zip Code

Email Address	Area Code/Phone Number	Email Address

Date	Date	Supreme Court Registry Number

IF YOU HAVE NOT RECEIVED NOTICE WITHIN 10 DAYS CALL 740-393-9510