Fill and Sign the Notice Crime Form

State of Minnesota District Court County Judicial District: Court File Number: Case Type: Criminal State of Minnesota, Plaintiff vs. Notice to Crime Victim Minn. Stat. §611A.06 , Defendant YOU HAVE THE RIGHT TO BE NOTIFIED IF THE DEFENDANT IS RELEASED or his or her custody status is reduced (for instance, if he or she is placed in a facility that is less secure). To be notified, you must make a written request to the head of the facility in which the defendant is confined. You may make a copy of this form, complete the bottom request portion and mail the form to:  The County Detention Facility at:  The Commissioner of Corrections at: Department of Corrections Attention: Records 1450 Energy Park Drive Suite 200 St Paul MN 55108-5219 YOU HAVE THE RIGHT TO BE NOTIFIED IF THE DEFENDANT REQUESTS EXPUNGEMENT (SEALING) OF HIS OR HER RECORD IN WHICH YOU ARE IDENTIFIED AS A VICTIM. You must make a written request to the prosecutor’s office to be informed if the defendant requests an expungement (sealing) of his or her record. You may make copies of this form and fill out the following to make your request. REQUEST TO BE NOTIFIED I wish to be notified:  Upon release or reduction in custody status of the above defendant. (If you checked this box, send this notice to the facility where the defendant is being held at the address provided above.)  If the above defendant requests expungement (sealing) of the criminal record. (If you checked this box, send notice to the prosecutor’s office that handled this offense.) My Name: Address: Phone: NOTE: Victim address and other identifying data provided to the prosecutor or facility for purposes of this notice may only be seen by the prosecutor, Department of Corrections records unit and the facility where the offender is held. You must notify the prosecutor and/or facility in writing if address is changed and you still want to be notified. EXP103 State ENG Rev 4/02-D www.courts.state.mn.us/forms Page 1 of 1