(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
__________ SS. __________ 20__
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 )for trial in the Superior Court under the
( complained of )
G. L. c. 218 § 30 ) (_____ Court of ______
( ) Hon.__________, Trial
provisions ( G.L. c. 219 §20 ) by the (Justice
of ( ) (_______________________
( St.1934 c. 358) (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.
Mass. R. Sup. Ct. 59