THE STATE OF OKLAHOMA, 1343299? I MAHOMA IN THE DISTRICT COUNTY BIS SawmPlaintiff, I 629/ REV. 03-2009 Vtawc guanier efendant. CASE NO. SSN: Slob? DOB: 12.2.4 3; CASE NO. - ADDRESS: CASE NO. 10. PLEA OF GUILTY AND SUMMARY OF FACTS I IS THE NAME JUST READ TO YOU YOUR TRUE IF NO, WHAT IS YOUR CORRECT I HAVE ALSO BEEN Ems; HIM/kin! MY I?h YOU HAVE A RIGHT TO HAVE A RECORD MADE OF THESE PROCEEDINGS BY A COURT REPORTER. DO YOU WAIVE THAT AGE: 2 CAN YOU READ AND UNDERSTAND THIS (IF THE ANSWER IS NO: COMPLETED ADDENDUM MUST BE ATTACHED) ARE YOU CURRENTLY TAKING ANY MEDICATION OR SUBSTANCES WHICH HIGHEST GRADE COMPLETED IN SCHOOL: I @9 no ECT Y9UR BILITY TO UNDERSTAND THESE x; YES NO HAVE YOU BEEN PRESCRIBE ARE NOT TAKING THEM AT THIS n: so - WHAT KIND AND FOR WHAT /IrrI f: WLIIbu?f'n' VI ANY MEDICATIONS THAT YOU SHOULD BE TAKING, BUT YOU 4% 1 anal/tad {Hus - 996 VE EVER BEEN TREATED BY A DOCTOR OR HEALTH PROFESSIONAL FOR MENTAL ILLNESS OR CONFINED IN A HOSPITAL FOR MENTAL IF YES, LIST THE DOCTOR OR HEALTH PROFESSIONAL, PLACE AND WH @wm Io axe/Megenm wanOMCe, dag/ig- ??fe mags LUng- DO YOU UNDERSTAND THE NATURE AND CONSEQUENCES OF THIS HAVE YOU RECEIVED A COPY OF THE INFORMATION AND READ THE THIS OCCURRED: magma YES NO ?9 NO 11. DOES THE STATE MOVE TO DISMISS 0R AMEND ANY CASES OR COUNTS IN THE INFORMATION OR ON PAGE 2 OF THE NO IF YESJ LIST THE CASES AND COUNTS TO BE AMENDED OR DISMISSED AND DETAILS: ul' Aer-Ltd .SI- an 4-9 pm; Md