Fill and Sign the District Court Denver Juvenile Court Court Address State Form

JDF 305 R3-18 PETITION FOR EXPUNGEMENT PURSUANT TO §42-4-1715(1)(b)(I), C.R.S. County Court _________________________ County, ColoradoCourt Address:State of Colorado v.Defendant: _______________________________________ COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail:FAX Number: Atty. Reg.#:Case Number:Division Courtroom PETITION FOR EXPUNGEMENT PURSUANT TO §42-4-1715(1)(b)(I), C.R.S. I, _______________________________________, (Defendant), petition the court for an expungement of my conviction under §42-4-1301(2)(d), C.R.S. (Underage Drinking and Driving with a blood alcohol level of at least .02 but no more than .05)1.Information about the Defendant: Date of Birth: _______________________Current Mailing Address: ___________________________________________________________City, State and Zip Code: __________________________________________________________Home Phone #: ________________ Work Phone #: _______________ Cell #: ________________2. I am over the age of 21 and have not been convicted of any other offense under §42-4-1301, C.R.S. while under the age of 21. 3. I have paid all fines, costs, restitution, and surcharges assessed and have completed all other requirements ordered in the case. The court action regarding the offense has been concluded.4.I have never held a commercial driver’s license and was not operating a commercial motor vehicle.5.I request that the following information be expunged: Date of OffenseName of Law Enforcement Agency Arrest Number 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.__________________________________________________________________________________________ SIGNATURE ___________________________________ ______________________________________ (Printed name of Defendant) Signature of Defendant Date ________________________________ Signature of Attorney, if applicable