Petition For Expungement Pursuant To Section 42-4-1715(1)(b)(l) C.R.S. {JDF 305}

JDF 305 R 3 - 1 8 PETITION FOR EXPUNGEMENT PURSUANT TO 247 42 - 4 - 1715(1)(b)(I), C.R.S. C ounty C ourt County, Colorado Court 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 247 42 - 4 - 1715 (1) (b)( I ), C.R.S. I, , ( Defendant ), petition the court for an expungement of my conviction under 247 42 - 4 - 1301(2)( d ), C.R.S. ( U nderage D rinking and D riving 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 247 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 ord ered in th e case. The court action regarding the offense has been concluded. 4. 5. I request that the following i nformation be expunged: Date of Offense Name o f 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 ( P rin ted name of Defendant ) Signature of Defendant Date Signature of Attorney, if applicable American LegalNet, Inc. www.FormsWorkFlow.com