JDF 242 R8 17 Notice of Direct Payment of Restitution /Motion to Modify Restitution County Court District Court Denver Juv enile Court 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 NOTICE OF DIRECT PAYMENT OF RESTITUTION MOTION TO MODIFY RESTITUTION Regarding: Victim Name: Total Restitution Owed: Total Restitution Interest Owed : Proof of payment must accompany this form for submission to the court. Date of Payment Dollar Amount Payment Type Check/MO Number Payor American LegalNet, Inc. www.FormsWorkFlow.com JDF 242 R8 17 Notice of Direct Payment of Restitution /Motion to Modify Restitution If you are the victim in the case, select only one of the following: 1. I am continuing to collect on the remaining balance due directly from the defendant(s). 2. I am no longer collecting from the defendant(s) as this restitution judgment, including any applicable interest, has been satisfied, either by payment in full or via a settlement agreement with the defendant. I certify that a copy of this notice has been filed with the District A County, Colorado. P order pursuant to 24718 - 1.3 - 603(3), m odifying the restitution and any accrued interest to reflect the same as I have reported as payment in full. Date: Signature of Victim Address / Telephone Information is Optional Address: City: State / Zip: Telephone: On , 20 a true and correct copy of this document was provided to the Defendant Victim , served by: Personal Service (Affidavit of Service attached) Personal Delivery Certified Mail Email Fax VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the , day of , , at (date) (month) (year) (city or other location, and state OR county) ( P rinted name) S ignature American LegalNet, Inc. www.FormsWorkFlow.com