(Applicable to criminal cases)

The form for an application to waive indictment under the provisions of G.L. Chapter 263, § 4A shall be as follows:


COMMONWEALTH OF MASSACHUSETTS

 

__________ 20__

______________,SS.
 

COMMONWEALTH 

v.
___________________

APPLICATION TO WAIVE INDICTMENT

To the Honorable the Justices of the Superior Court:

Respectfully represents said defendant that on ___________, 20__, he was (committed) (bound over) (complained of) for trial in the Superior Court under the provisions of (G.L. c. 218 § 30 ) (G.L. c. 219 § 20 ) (St.1934 c. 358 ) by the (Court of ___________ ) (Hon. ______________, Trial Justice ___________) ( District Attorney for the ___________ District ) upon a complaint numbered ___________ of 20___ charging him with a crime not punishable by death; that he desires to waive indictment upon said charge and now applies for leave to waive such indictment and for prompt arraignment on such complaint.

____________________________________________

I hereby consent to the foregoing application.

_________________________________

District Attorney for the _________ district.

Approved By the Court ___________ Clerk.

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