IN THE MUNICIPAL COURT OF IOLA, KANSAS. CITY OF IOLA, KANSAS, ) Plaintiff, ) vs. ) 10 ), ) Defendant. DIVERSION AGREEMENT

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1 IN THE MUNICIPAL COURT OF IOLA, KANSAS CITY OF IOLA, KANSAS, Plaintiff, vs. 10, Defendant. DIVERSION AGREEMENT This Diversion Agreement, made and entered into this day of, 20, by and between, hereinafter referred to as Defendant, represented by and through, Attorney, and the City of Iola, Kansas who is represented by Charles H. Apt III, hereinafter referred to as the City. The Defendant,, is years of age; date of birth is / / ; SSN: address is Race: Sex : male female The Defendant was charged on the day of 20 with the following offense(s of: Count 1 Count 2 Count 3 Count 4 filed in the Municipal Court of Iola, Kansas, Case No. and that this case and charges are in full force and effect. By initialing the following conditions, the parties hereto stipulate and agree to the following conditions:

2 DIVERTEE MUST INITIAL ALL APPLICABLE STIPULATIONS 1. You knowingly, voluntarily, and with/without the assistance of counsel waive all rights under the State and Federal constitutions to a speedy arraignment and hearing, speedy trial, trial by jury, and in a felony case, preliminary hearing. 2. You understand that every accused has the right to a trial, the right to confront and cross-examine witnesses, the right to present evidence and testify on your own behalf and the right to compel the attendance of witnesses through subpoenas. 3. You understand that the burden at trial would be upon the State to prove you guilty beyond a reasonable doubt and that you would be presumed innocent throughout the trial. 4. You understand that the charges pending against you will remain in full force and effect during the period of Diversion and that violation of any term of this agreement will result in resumption of the criminal proceedings. 5. You shall not violate any laws of the United States, of any state, or ordinances of any municipality. 6. You will be supervised through the City of Iola, Kansas Diversion Program, follow all recommendations as requested, and are to report thereto as directed by the Court. 7. You understand that you have a right to have the assistance of an attorney. If you are indigent or poor and unable to employ an attorney, the Court will appoint one for you. 8. You shall pay the following court costs to the Clerk of the Municipal Court, which are to be paid in full within 45 days of signing the agreement and its approval by the court. Court Costs: $ Fine: 1.$ Failure to pay within the 45 day period will result in the automatic revocation of your diversion 9. You shall pay a Diversion Fee in the amount of $ to the Municipal Court of Iola, Kansas upon signing the Diversion. 10. You agree that in the event that this Diversion Agreement is revoked by the Court, you will admit that the contents of any uniform notice to appear, complaint, affidavit if one is filed in support of the complaint or notice to appear, accompanying reports if any and the results of any blood, breath, or urine tests taken, are true and correct and that the trial, or in a felony case, a preliminary hearing, shall proceed to the Court upon these stipulated facts. 11. You understand that the Court must be notified of any change in employment or residence address.

3 12. You shall report on a monthly basis using the forms provided by the Court. One form shall be delivered by the 15 th day of each month during the Diversion. 13. You are ordered to pay any additional costs or fees that become due and owing during the term of the Diversion. All costs or assessments ordered will be subject to additional collection fee of at least 33% through the Municipal Court Clerk, if not paid as ordered. 14. You shall not consume alcohol or illegal drugs or be present anywhere alcohol or drugs are sold, dispensed, or consumed, except grocery stores or establishments whose primary purpose is the sale of food. 15. You shall have no contact or violent contact with the victim in this case unless otherwise authorized by the Court. 16. You shall be truthful with the Court in all matters. 17. You shall submit to breath, blood, urine, or other bodily fluid testing at any time when requested to do so by the Court, any Law Enforcement Officer, or Probation Officer or a designated representative of the City of Iola. Failure to submit will be considered a violation of your Diversion. Costs of those tests will be your responsibility. You agree by acceptance of these conditions that any test results of bodily fluids or breath may be entered into evidence by the Court without the testimony of any laboratory personnel. 18. You shall execute and maintain the necessary releases authorizing any and all treatment providers to communicate with the Court or designated representative of the City of Iola. 19. You shall complete an Anger Screening through the Mental Health Center or at a certified facility of your choice within 90 days after signing into the Diversion Agreement. Any recommendations that are made, must be followed during you Diversion. A copy of the evaluation/report must be sent to my office at P.O. Box 328 Iola, Kansas 66749, or faxed to ( Community Service. As part of your diversion you shall complete hours of Community Service. If you are not a resident of Iola or Allen County you may make arrangements to perform said service in your local community with prior approval of the Iola Municipal Court. 21. SPECIAL CONDITIONS FOR DUI: Divertee shall obtain alcohol/drug treatment as recommended by the ASAP evaluating agency and pay all costs of treatment. (1 You shall not violate any federal, state or local law; (2 You shall pay the diversion fee, fine, Court costs and ASAP Assessment within the time stated above; (3 You shall attend and successfully complete the Alcohol Information School and pay the required fee; (4 You shall complete all treatment recommended as set forth in the Special Conditions above; and (5 You shall stay out of taverns and bars.

4 22. NOTICE OF REVOCATION OF DIVERSION: In the event that the City Attorney elects to institute revocation proceedings against you under this agreement, you agree that a notice of those revocation proceedings sent to your last known address via certified mail, shall, upon dispatch by the City Attorney, constitute sufficient notice to you of any revocation proceedings. In the event that you fail to appear pursuant to certified mail notice, the City Attorney will ask that a bench warrant for your arrest be issued without further notice. NOW, THEREFORE, IN CONSIDERATION of the above-stated stipulations, and in consideration of the mutual promises and agreements herein contained, the City further agrees that if the Defendant successfully fulfills the terms of this Diversion Agreement, the criminal charges filed against the Defendant will be dismissed with prejudice. FURTHER, if the City finds that at the termination date of this Diversion or at any time prior thereto, that the Defendant has failed to fulfill any of the terms of this Diversion Agreement, the matter will be set for hearing to determine if a violation of said agreement has occurred, and is so, the criminal proceedings against the Defendant shall resume. FURTHER, the Defendant be and hereby is released pending trial or disposition of this matter for a period of [six (6 months/one (1 year], conditioned upon the successful completion of this Diversion Agreement. The below signed parties have read, understand, and agree to the terms and conditions of the Diversion Agreement. APPROVED: Brett Heim City of Iola, Kansas Attorney APPROVED & AGREED: Attorney for Defendant DATED: DATED:, Defendant DATED:

5 IN THE MUNICIPAL COURT OF IOLA, KANSAS CITY OF IOLA, KANSAS, Plaintiff, vs. Case No. Defendant. STAY ORDER NOW, on this day of, 20, the Court hereby finds that the parties have entered into a Diversion Agreement and that this action should be stayed pursuant to K.S.A The Court further finds that the action shall be automatically dismissed with prejudice upon expiration of the Diversion period (six (6 months/one (1 year, as provided in said agreement unless a revocation motion is filed with the Court prior to the end of said Diversion period. IT IS FURTHER BY THE COURT ORDERED that said Defendant shall be supervised, in accordance with the Diversion Agreement, by the Court of the City of Iola, Kansas or a person designated by the Court. IT IS SO ORDERED. SUBMITTED & APPROVED: Thomas M. Saxton Jr. Municipal Court Judge Brett Heim Attorney for City of Iola, Kansas Attorney for Defendant

6 IN THE MUNICIPAL COURT OF IOLA, KANSAS CITY OF IOLA, KANSAS Plaintiff, vs., Defendant. STIPULATION OF FACTS 1. On or about the day of, 20, did you being an individual and that location being within the corporate limits of the City of Iola, Kansas? yes no. 2. Statement of divertee (if any: Date: Divertee- Date: Attorney for Divertee Date: Brett Heim, Iola City Attorney