Fill and Sign the About Adult Probation and Parole Utah Department of Form

Response by Adult Probation and Parole Approved Board of District Court Judges October, 2012 Page 1 of 3 My Name Address City, State, Zip Phone Email I am the Representative of Adult Probation and Parole In the [ ] District [ ] Justice Court of Utah __________ Judicial District ________________ County Court Address ______________________________________________________ In Re Petition to Expunge the Records of _____________________________________ Petitioner Response by Adult Probation and Parole _______________________________ Case Number _______________________________ Judge (1) Choose one: (A) [ ] Petitioner was not on probation or parole for the conviction identified in the petition. (B) [ ] Petitioner was terminated from [ ] probation [ ] parole because: Response by Adult Probation and Parole Approved Board of District Court Judges October, 2012 Page 2 of 3 (2) Petitioner has completed all requirements of (Choose all that apply) [ ] sentencing [ ] probation [ ] parole (3) Petitioner has not completed all requirements of (Choose all that apply.) [ ] sentencing [ ] probation [ ] parole Petitioner still has to complete the following requirements: (4) Response to any further requests by the court: I have not included any non-public information in this document. I declare under penalty of Utah Code Section 78B-5-705 that everything stated in this document is true and correct. Sign here ► Date Typed or Printed Name Response by Adult Probation and Parole Approved Board of District Court Judges October, 2012 Page 3 of 3 Certificate of Service I certify that I served a copy of this document on the following people. Person’s Name Method of Service Served at this Address Served on this Date (Petitioner) [ ] Mail [ ] Hand Delivery [ ] Fax (Person agreed to service by fax.) [ ] Email (Person agreed to service by email.) [ ] Left at business (With person in charge or in receptacle for deliveries.) [ ] Left at home (With person of suitable age and discretion residing there.) (Prosecuting Attorney) [ ] Mail [ ] Hand Delivery [ ] Fax (Person agreed to service by fax.) [ ] Email (Person agreed to service by email.) [ ] Left at business (With person in charge or in receptacle for deliveries.) [ ] Left at home (With person of suitable age and discretion residing there.) Sign here ► Date Typed or Printed Name