Fill and Sign the Defendantsjuveniles Request to Form

INSTRUCTIONS FOR COMPLETING DEFENDANT'S/JUVENILES REQUEST TO RELEASE SEALED RECORDS HEADING • Enter the name of the county where you are filing the request. •This is the county where the sealed record you want released can be found. • Check the box next to what kind of c ase this is NOTE: These check boxes and names will NOT print on your completed form. •In County or District Court Cases: •Enter your first, middle, and last names. You are the defendant. • In Juvenile Cases: •Enter your first, middle and last names. You are the juvenile. • Enter the case number of the case in which you are requesting the sealed records to be released. BODY OF THE REQUEST •In the blank following “I” enter your name. • check the box of who the copies are to be released to. o If you check the box for someone else to get the copies, provide their nam e and addr ess. NOTE: if that other person is going to pick up the copies, they will have to provide valid identification before the records can be released to them. • check the box fo r either the "entire case file" or "following documents." o If you check for just some of the documents, be specific about what you ar e as king for. You can list them on the lines provided. • check the box for who is paying for the copies. FINAL SIGNATURE •ONLY WHEN YOU ARE BEFORE A NOTARY PUBLIC, on the first line sign your first, middle, and last names and enter the date. • On the second line enter your first, middle, and last names. • On the third line enter your full street address. • On the fourth line enter your city, state, and ZIP code. • On the fifth line enter your telephone number, including the area code, and your e- ma il addr ess, if any. The notary public will fill out the date at the end of the Affidavit and will sign his or her name in the last blank. Page 1 of 1 DC 1:12a NEW 06/19