Assault Robot Step 1 of 11 0% Representing yourself in court for assault? Please fill in this form if you are going to Court for a minor assault charge and want to represent yourself on a guilty plea. Be honest and clear with your responses. Details about your income and personal circumstances will be asked by the robot. These information are necessary so that the resulting document could provide relevant information to the court. For instance, the Court needs to know your income should it decide to impose a fine as a penalty. None of the information is stored on the website. Personal InformationName* First Last Date of Birth* DD MM YYYY Email* Your email address is only ever used once to forward you the document you create. It is not saved and not used for any other correspondence, nor provided to a third party. Charge InformationThe Assault Robot service is only to be used if you are pleading guilty to a minor offence which you do not dispute or contest the facts. If you are pleading not guilty (i.e. disputing or contesting the facts in your case), we suggest you engage a lawyer or contact a service that will provide you with legal advice.I am pleading*guiltynot guiltyThis Assault Robot service is only for those pleading guilty to minor assault offences. It is designed to assist those who cannot access nor afford legal representation. Have you previously been found guilty at Court for a criminal or driving charge?YesNoIf you have answered yes to the question relating to previous charges, Assault Robot suggests that you seek legal representation. However, it is recommended that you complete this document in order to assist your lawyer. EmploymentYour work or lack of work is important in deciding a penalty.Current Employment StatusEmployedUnemployedLooking For WorkStudyingWhat are you studying and where?Job TitleWorking HoursFull TimePart TimeHow long have you been looking for work?My weekly income / earnings / government benefits are approximately(Please insert the amount after tax is paid)How much do you have left after you have paid all your bills?(Bills may include rent, mortgage, transport, phone/internet, gas or power bills, food) RelationshipsYour relationships can be a factor to consider in deciding a penalty.Relationship StatusSingleMarriedDe FactoWidowedSeparatedDivorcedI liveWith ParentsWith HusbandWith WifeWith PartnerWith ChildrenWith FriendsAloneNumber of Children Living With Me Personal CommitmentsPersonal commitments can be important in deciding a penalty.Are you involved in community activities?YesNo(These may include sporting clubs, church, youth groups, charity or other volunteer work)I am involved in the following community activities HealthYour health can be important in deciding a penalty.Do you have any physical health problems the Court should be aware of?YesNoPlease give details of your diagnosis and list any medication you are on:If you have health issues, you should consider getting a letter from your doctor or medical specialist as it may assist the Court in determining your penalty. Are you currently consulting a psychiatrist or psychologist? Have you engaged in any counselling or therapy since the assault?YesNoPlease give brief details of your diagnosis:If you are consulting a mental health professional, you should consider getting a letter from the person you have been seeing as it may assist the Court in determining your penalty. Offence DetailsWas there an injury from the assault?YesNoIf you have answered yes to the question of was there an injury from the assault, Assault Robot suggests that you seek legal representation. However, it is recommended that you complete this document in order to assist your lawyer. Do you have an ongoing relationship with the victim of your assault?YesNoPlease detail the state of your relationship at present: Personal GrowthThese personal details can be helpful in deciding an appropriate penalty.Do you want to explain why you committed the offence?YesNoPlease outline the reasons for your offending:Have you learned anything positive from your offending?YesNoWhat lessons have you learned from your offending? Explain below:Do you think that going to Court for this offence has changed your attitude?YesNoExplain how your attitude will be different in the future:Do you want to tell the Court why you are not at risk of committing an assault offence in the future?YesNoI believe I am not a risk to commit this type of offence in the future because: Terms*I understand that the Assault Robot is not a real lawyer. The reading or use of information from this website does not create a client-lawyer relationship. I understand that this form is not legal advice.You have now completed all fields, feel free to go back and review your answers. If you are satisfied with the information you have entered, please click submit. We do not save your information, therefore, once you have submitted your answers, you cannot review this document again, although you may complete the form again if you wish. You will receive an email with a Personal Instructions document and a Character Reference Guide Please print 2 copies of the document and take them with you to Court (one for the Court and one for yourself). This iframe contains the logic required to handle Ajax powered Gravity Forms.