RULE 6.1.2
                     TRIAL BY THE COURT

    (a) Trial Without Jury. In a case tried without a jury, the court shall
state separately findings of fact and conclusions of law.
    (b) Stipulation or Submittal. A defendant, with the approval of the
prosecuting authority, may submit his or her case upon the police report
and other materials by stipulating to the admissibility thereof in lieu of
testimony. A written statement of the defendant in substantially the form
set forth below may be filed:

                    STATE OF WASHINGTON

COUNTY OF______________,   )              Case No. ______
THE STATE OF WASHINGTON,   )
CITY OR TOWN OF________,   )
        Plaintiff,         )                   STATEMENT OF DEFENDANT
      v.                   )                       ON SUBMITTAL OR
_______________,           )                    STIPULATION OF FACTS
        Defendant.         )

    I am the defendant in this case. I wish to submit the case on the
record. I understand that this means that the judge will read the police
report and other materials and, based upon that evidence, the judge will
decide if I am guilty of the crime(s) of ___________________________.
    I understand that, by this process, I am giving up the constitutional
right to a jury trial, the right to hear and question witnesses, the right
to call witnesses in my own behalf, and the right to testify or not to
testify.
    I understand that the maximum sentence for the crime(s) is
______________________________________________________________________
and that the judge can impose any sentence up to the maximum, no matter
what the prosecution or the defense recommends.
    No one has made any threats or promises to get me to submit this case
other than the prosecuting authority's promise to take the following action
and/or make the following recommendations:
______________________________________________________________________
_____________________________________________________________________.
    Dated this _______ day of ____________________, 19____.

                                     _________________________________
                                                Defendant
________________________________     _________________________________
  For the Prosecuting Authority            Lawyer for Defendant