An example of the Affidavit of Plea and Sentence used by Queens County during Covid-19.

1. 1
CRIMINAL COURT OF THE CITY OF NEW YORK
COUNTY OF QUEENS: PART T-4
THE PEOPLE OF THE STATE OF NEW YORK
-against-
[NAME],
Defendant.
AFFIDAVIT OF PLEA
AND SENTENCE
Docket No.: [docket]
I, [NAME], the defendant in this criminal action under docket number [docket], hereby affirm
under penalty of perjury that:
1. I am the defendant named in the above-captioned case.
2. I currently reside at [address].
3. My attorney, [attorney name & office], has informed me that I have the
constitutional and statutory right to be present at all stages of the criminal proceeding against me,
including the right to enter a plea in person and the right to be personally present at the time that
sentence is pronounced.
4. I understand that given the current state of emergency due to the COVID-19
pandemic, it is logistically impractical and medically risky for me to personally appear in court for
the entry of my guilty plea and for sentencing. Therefore, pursuant to Criminal Procedure Law §
340.20(2)(a), I waive my right to enter a guilty plea in person. Additionally, pursuant to Criminal
Procedure Law § 380.40(2), I waive my right to be personally present at the time that sentence is
imposed.
5. I authorize my attorney, [attorney name], to enter a plea of guilty on my behalf, in
my absence, to the added and reduced charge of Disorderly Conduct, Penal Law § 240.20, a
violation. I understand that this plea will not give me a criminal record in the State of New York.
I also understand that while the court could impose a sentence of imprisonment of up to fifteen
days for this offense, I will receive a sentence of [time served / a one-year conditional discharge],
[add if applicable:] and the court will issue a final [full / limited] order of protection in favor of
[name], which will remain in effect for a period of two years.
6. I waive prosecution by information and formal allocution. I am pleading guilty to
the charge of Disorderly Conduct, Penal Law § 240.20, knowingly and voluntarily. No one has

2. 2
forced or threatened me to take this plea, and I am pleading guilty of my own free will. No
promises, apart from the promised sentence stated above, have been made to me in order to induce
me to plead guilty.
7. I understand the charges against me. I also understand that by pleading guilty, I am
giving up certain important constitutional rights, including the right to a jury trial and, at such trial,
to confront and cross-examine the witnesses against me, to testify or remain silent, to call witnesses
on my behalf, and to have the District Attorney prove my guilt beyond a reasonable doubt. I
understand that a plea of guilty has the same legal effect as if I was found guilty after trial. I
knowingly, voluntarily, and with the advice and assistance of counsel, waive all of these rights.
8. I have reviewed the collateral consequences of this plea with my attorney. I
understand that if I am not a citizen of the United States, this plea may have negative immigration
consequences for me, including deportation, exclusion from admission, or denial of naturalization.
Knowing this, I still wish to proceed with the plea.
9. I have reviewed the accusations against me with my attorney, as well as the
elements of the charge to which I am pleading guilty.
10. I am pleading guilty to the offense of Disorderly Conduct because I am guilty. I
admit that on [date], at about [time], at [location], in Queens County, New York, I committed the
offense of Disorderly Conduct.
11. I authorize my attorney, [attorney name], to appear on my behalf, in my absence,
for sentencing. I understand that upon the entry of my guilty plea, the court will impose a sentence
of [time served / a one-year conditional discharge]. [Add if conditional discharge:] I also
understand that the conditions of the conditional discharge sentence are: (1) I must lead a law-
abiding life; (2) I must not be re-arrested; and [add if applicable:] (3) I must abide by the terms of
the two-year final [full / limited] order of protection in favor of [name].
12. [Add if applicable – FULL] I understand that a full order of protection means that I
must stay away from the individual named in that order as well as that individual’s home, school,
business and place of employment, and that I cannot have any contact or communication by any
means with that individual. I understand that if I violate any of the terms of the order of protection,
I may be re-arrested and prosecuted on additional charges.
[Add if applicable – LIMITED] I understand that a limited order of protection means that I may
have contact with the individual named in that order, but I cannot assault, stalk, harass, menace,

3. 3
intimidate, threaten, or commit any other criminal offense against that individual. I understand that
if I violate any of the terms of the order of protection, I may be re-arrested and prosecuted on
additional charges.
13. [Add if conditional discharge:] I further understand that if I violate any of the
conditions of the conditional discharge sentence set forth above, I may be re-sentenced on this case
to a term of imprisonment of up to fifteen days.
14. I understand that I must pay a mandatory court surcharge of $120.
� I will need time to pay the surcharge.
� I am indigent and request the court to enter civil judgment on the surcharge.
________________________________ _____________
[NAME] DATE
Subscribed and sworn to before me this
_____ day of _______________, 2020.
____________________________
NOTARY PUBLIC
[STAMP]