Waiver of Right to Counsel (Pro Se)

← FORMVANA NC FORMS VIEW ALL FORMS →

Important: Filing this form does not complete the waiver. The court must question the defendant in open court to confirm the waiver is knowing, voluntary, and intelligent under G.S. 15A-1242 and Faretta. This document establishes a record and initiates the judicial colloquy.

01 DEFENDANT INFORMATION

Full Legal Name *

Date of Birth *

Education Level *

Current Address

Phone

02 CASE INFORMATION

Case / File No. *

County *

Division

Charges Pending *

03 PRIOR CONSULTATION WITH ATTORNEY

Has the defendant consulted with an attorney before making this election? *

04 DEFENDANT'S ACKNOWLEDGMENTS

Defendant confirms understanding and voluntary agreement with each of the following. All must be acknowledged to proceed.

I understand I have the right to be represented by an attorney at all stages of this proceeding, including at trial I understand that if I cannot afford an attorney, one will be appointed by the court at no cost to me I understand the dangers and disadvantages of self-representation — I will be held to the same rules of evidence and procedure as a licensed attorney I understand the court may appoint standby counsel to assist me during the proceedings even if I waive the right to full representation I understand that I may revoke this waiver and request appointed or retained counsel at any time before trial begins This waiver is made freely, voluntarily, knowingly, and intelligently — I have not been coerced, threatened, or promised any benefit to waive counsel

05 REASON FOR WAIVING (OPTIONAL)

Defendant's reason for electing to proceed without counsel (optional — court may ask)

06 SIGNATURE BLOCK

The PDF will include a signature line for the defendant. The court retains a copy. Sign in open court after the judicial colloquy.

Date of Filing

DEFENDANT'S SIGNATURE WILL APPEAR HERE

Defendant's Signature · Date

SELECTED COUNTY

— Select above —

WHAT YOU NEED TO KNOW

Court must conduct a colloquy before accepting this waiver — this form is not self-executing
Waiver can be revoked at any time before trial begins — you may request counsel up until that point
Court may appoint standby counsel even if waiver is accepted — you can ask for this
Felony charges require extra judicial scrutiny of any waiver under G.S. 15A-1242
You will be held to the same procedural standards as a licensed attorney
Strongly consider consulting an attorney before making this election

LEGAL AUTHORITY

G.S. 15A-1242Waiver of counsel

Faretta v. Cal.422 U.S. 806 (1975)

State v. Watkins361 N.C. 621 (2007)

Indiana v. Edwards554 U.S. 164 (2008)

NEED LEGAL HELP?

Self-representation in criminal cases is high-risk. Contact an attorney before giving up your right to counsel.

BARKER RICHARDSON, PLLC →

FREE LEGAL RESOURCES

NC Public Defender →
NC Bar Lawyer Referral →
ResetMyCourtDate.com → missed court dates