Fill and Sign the Colorado Criminal Form

 District  County Court _______________________County, Colorado Court Address: Petition of: Defendant (Primary subject of the criminal justice record) COURT USE ONLY Case Number: Division: Courtroom: MOTION TO SEAL CRIMINAL JUSTICE RECORDS PURSUANT TO §24-72-702.5, C.R.S. I, _________________________________________________ (defendant’s name), am the defendant in the above captioned case. Defendant’s Name: Date of Birth:__________________________________ Current Mailing Address: City:__________________State: Zip Code: Phone: __________________________  I was acquitted of all charges on ______________________________________________________.  The case was completely dismissed on ________________________________________________, and the dismissal was not part of a plea agreement in a separate case.  I completed a diversion agreement on _________________________________________________.  I completed a deferred judgment and sentence on _______________________________________, and the deferred judgment and sentence does not pertain to any of the following offenses: - Driving Under the Influence (DUI), Driving While Ability Impaired (DWAI), or DUI Per-Se pursuant to § 42-4-1301(1) or (2), C.R.S., - An offense concerning the holder of a commercial driver’s license or the operator of a commercial motor vehicle pursuant to § 42-2-402, C.R.S. - An offense for which the factual basis involved unlawful sexual behavior pursuant to § 16-22-102(9), C.R.S. I have paid any and all restitution, fines, court costs, late fees or other fees ordered by the Court, or the Court has vacated such order(s). The records in this case do not pertain to a class 1 misdemeanor traffic offense, class 2 misdemeanor traffic offense, class A traffic infraction, or a class B traffic infraction. Agencies having records related to this case are:  Sheriff’s Department  District Attorney  Colorado Bureau of Investigation (Statute authorizes this agency to assess an additional fee to seal its records) Law Enforcement Agency (identify): _____________________ Other: _____________________ _____________________ Arrest number (from fingerprint card): Date: JDF 477 R5/18 MOTION TO SEAL CRIMINAL JUSTICE RECORDS, PURSUANT TO §24-72-702.5, C.R.S. I respectfully request that any criminal justice records, except identifying information, related to this case be sealed promptly pursuant to § 24-72-702.5, C.R.S.  By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form.  By checking this box, I am acknowledging that I have made a change to the original content of this form. VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the ______ day of ________________, _______, at ______________________________________ (date) (month) (year) (city or other location, and state OR country ___________________________________ ______________________________________ (Printed name of Defendant) Signature of Defendant CERTIFICATE OF MAILING I certify that on __________________ (date) a true and accurate copy of this Motion to Seal Criminal Justice Records Pursuant to §24-72-702.5, C.R.S . was served on the Prosecuting Attorney by:  Hand Delivery  E-filed  Faxed to this number ____________________ or  by placing it in the United States mail, postage pre-paid, and addressed to the following: ________________________________ ________________________________ ________________________________ ____________________________________ Signature of Petitioner JDF 477 R5/18 MOTION TO SEAL CRIMINAL JUSTICE RECORDS, PURSUANT TO §24-72-702.5, C.R.S.