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appendix-page-25 — Appendix or form source excerpt — physical PDF page 25

Linn County Supplementary Local Rules (2026) · physical PDF page 25 · 2026

24 February 1, 2026 
Linn County Circuit Court 
23rd Judicial District 
 
Appendix A 
 
 
IN THE CIRCUIT COURT OF THE STATE OF OREGON 
FOR THE COUNTY OF LINN 
 
 
 
 
)   CASE NO. _____________________  
vs.      )  
     ) 
)  WAIVER AND DECLARATION UNDER  
)  PENALTY OF PERJURY  
_________________________________    )  (For Violation Trials)  
      Defendant.                   )  
 
I, the undersigned Defendant, having entered a plea of Not Guilty to the Violation(s) charged in the above 
case, hereby submit this declaration under penalty of perjury in lieu of my personal appearance at trial. Although I 
do not give up my right to a trial, I do waive my right to appear at trial, to offer oral testimony in open court at trial, 
and to confront any witnesses called against me. I further understand and con sent that the State’s witnesses may 
appear at said trial and give oral testimony, or may submit written testimony.  
 
I further acknowledge that I have received and read the Linn County “Court Rules for Traffic and Other Violation 
Trials.”  
 
My testimony is as follows (attach additional sheet if necessary):________ _________________________________ 
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_________________________________________________________ ____________________________________
_____________________________________________________________________________________________  
 
I hereby declare that the above statement is true to the best of my knowledge and belief, and that I understand it is 
made of use as evidence in court and is subject to penalty of perjury.  
 
DATED this ________ day of __________________, 20_______.  
 
 
________________________________________  
Defendant Signature

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