Fill and Sign the Petition to Seal Criminal Conviction Municipal Records Form

JDF 683 R8/19 PETITION TO SEAL CRIMINAL CONVICTION MUNICIPAL RECORDS Page 1 of 3 District Court _________________________ County, Colorado Court Address: Petition of: Defendant (Primary subject of the criminal justice record) COURT USE ONLY Attorney or Party W ithout Attorney (Name and Address): Phone Number: E-mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom PETITION TO SEAL CRIMINAL CONVICTION MUNICIPAL RECORDS 1. The Petitioner is: (check one only) ❑ the Defendant and the primary subject of the criminal conviction record. ❑ the designated representative of the Defendant, by power of attorney or notarized authorization. ❑ the parent of the Defendant , if Defendant is under legal disability. ❑ the appointed legal representative of the Defendant , if Defendant is under legal disability. 2. Information about the Defendant: Date of Birth: ______________________________ ___ Current Mailing Address: City : State: Zip Code : Home Phone #: Work Phone #: Cell #: 3. The Petitioner asks this Court for an Order to Seal the Criminal Conviction Municipal Records in the custody of the following agencies: ❑ Municipal Courts Case Number: ___________________________ ❑ Sheriff’s Department ❑ District Attorney ❑ City Attorney ❑ Law Enforcement Agency (Identify) Case Number:  Colorado Bureau of Investigation (Any Order granting a petition to seal crimina l conviction records must be sent to the Colorado Bureau of Investigation.) ❑ Other : 4. Informat ion about the criminal conviction to seal is as follows: Identify offense(s) convicted of in t he case requesting to seal: ❑ Municipal Violation(s) of _____________________________________________________ ___ ______ Date Sentenced: Probation/Parole Supervision Termination Date: 5. Was this case appealed? ❑ Yes ❑ No If yes, please provide the following information: JDF 683 R8/19 PETITION TO SEAL CRIMINAL CONVICTION MUNICIPAL RECORDS Page 2 of 3 Appeal Case Number: _______ ___________________________________________ Appellate Court: _______________________________________________________ Result: ____________________________ Date: ___________________________ 6. A current verified copy of the Defendant’s criminal history re cord is attached , and the criminal history record check was conducted no more than 20 days prior to the filing of this Petition. ❑ Yes ❑ No (If it is not attached to this Petition , a copy of the criminal history record must be filed with the Court no later than 10 days after the filing of this Petition) 7. The Defendant has paid all restitution, fines, court costs, late fees or other fees ordered by the Court, unless the Court has vacated the Order in the case requesting to be sealed. ❑ Yes ❑ No 8. The Petitioner further shows the Court that the harm to Defendant’s privacy or the danger of unwarranted , adverse consequences outweighs the public interest in retaining the records. Explain: 9. The Petition is for a conviction eligible for sealing under § 24 -72 -708 C.R.S 10. The case I am requesting be sealed contains at least one charge that is not a cl ass 1 misdemeanor traffic offense, class 2 misdemeanor traffic offense, class A traffic infraction, or class B traffic infraction. 11. I understand sealing is not available for records pertaining to a deferred judgement and sentence c oncerning the holder of a commercial driver’s license or the operator of a commercial motor vehicle pursuant to § 42 -2- 402, C.R.S. , or a n offense for which the factual basis involved unlawful sexual behavior pursuant to § 16 -22 - 102(9), C.R.S. 12. If, subsequent to the conviction in t he case I am requesting be sealed, I have been convicted of a single offense that was not a felony and did not involve domestic violence as defined in § 18 -6-800.3(1), unlawful sexual behavior as defined in § 16 -22 -102(9), or child abuse as defined in § 18 -6-401, I understand sealing is not available for records pertaining to a municipal assault or battery offense, as defined in § 18 -6-800.3(1) or any other municipal violation in which the underlying factual basis involves domestic violence as defined in § 18 -6- 800.3(1). 13. Petitioner requests the Court to enter an order sealing criminal conviction records pertaining to the Defendant, pursuant to § 24 -72 -70 3 and § 24 -72 -708 C.R.S., and to seal this action. ❑ By checking this box, I am acknowledging I am filling in the blanks and not changing anything el se 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 Petit ioner) Signature of Petitioner Date _______________________ ____________ ___ Signature of Attorney Date JDF 683 R8/19 PETITION TO SEAL CRIMINAL CONVICTION MUNICIPAL RECORDS Page 3 of 3 CERTIFICATE OF SERVICE I certify that on __________________ (date) a true and accurate copy o f this Petition to Seal Criminal Conviction Records 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