JDF 612 R 8/19 MOTION TO SEAL CRIMINAL CONVICTION RECORDS Page 1 of 3 District Court County Court County, Colorado Court Address: People of the 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 MOTION TO SEAL CRIMINAL CONVICTION RECORDS efendant in the above captioned case. 1. Information about the Defendant: Date of Birth: Current Mailing Address: City : State: Zip Code : Home Phone #: Work Phone #: Cell #: 2. The Pet itioner asks this Court for an Order to Seal the Criminal Conviction Records i n the custody of the following agencies: District and County Courts Case Number: Municipal Courts Case Number: Sher District Attorney City Attorney Law Enforcement Agency (Identify) Case Number: Colorado Bureau of Investigation (Any Order granting a petition to seal criminal conviction records must be sent to the Colorado Bureau of Investi gation.) Other : 3. Informat ion about the criminal conviction t o seal is as follows: Identify offense(s) convicted of in t he case requesting to seal: Petty Offense (s) of Misdemeanor Offense (s) of Felony Offense (s) of Date Sentenced: American LegalNet, Inc. www.FormsWorkFlow.com JDF 612 R 8/19 MOTION TO SEAL CRIMINAL CONVICTION RECORDS Page 2 of 3 Probation/Parole Supervision Termination Date: 4. Was this case appealed? Yes No If yes, please provide the following information: Appeal Case Number: Appellat e Court: Result: Date: 5. the criminal history record chec k 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 C ourt no later than 10 days after the filing of this Petition) 6. 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 7. If requesting the sealing of a ny conviction (s) other than a petty offense or petty drug offense, t he Defendant further shows the Court that t , adverse consequences outweighs the public interest in retaining the records. Explain: 8. The Motion is for: (check the one box that applies) A conviction eligible for sealing under 24 - 72 - 706, 247 24 - 72 - 707, or 247 24 - 72 - 708 C.R.S ; A misdemeanor offense that is not eligible for sealing under 247 24 - 72 - 70 6 , C.R.S., however the district attorney consents to sealing . A misdemeanor offense that is not eligible for sealing under 247 24 - 72 - 706, C.R.S. , however, I am requesting the court to find by clear and convincing evidence that the need for sealing the record is significant and substantial , the passage of t ime is such that I am no longer a threat to public safety, and the public disclosure of the record is no longer necessary to protect or inform the public. Explain: 9. The conviction records do not fall under any of the following: When the only charges in a case are: o Class 1 or Class 2 misdemeanor traffic offenses o Class A or Class B traffic infractions A conviction for a violati on of C.R.S. 247 42 - 4 - 1301(1) or (2); A conviction for an offense for which the underlying basis involved unlawful sexual behavior as defined in C.R.S. 247 16 - 22 - 102(9); A conviction for a violation of C.R.S. 247 18 - 6 - 401; A conviction that is subject to one or more of the following provisions: Sentences for a crime involving extraordinary aggravating circumstances pursuant to C.R.S. 18 - 1.3 - 401 (8); A sentence for an extraordinary risk crime pursuant to C.R.S. 247 18 - 1.3 - 401 (10); Sentencing for a crime involving a pregnant victim pursuant to C.R.S. 247 18 - 1.3 - 401(13); Sentencing for a crime pertaining to a special offender pursuant to C.R.S. 247 18 - 18 - 407; American LegalNet, Inc. www.FormsWorkFlow.com JDF 612 R 8/19 MOTION TO SEAL CRIMINAL CONVICTION RECORDS Page 3 of 3 Sentencing for a criminal conviction for which the underlying factual basis invo lves domestic violence as defined in C.R.S. 247 18 - 6 - 800.3; Sentencing for a criminal conviction for a sexual offense pursuant to Part 4 of Article 3 of Titled 18 of the Colorado Revised Statutes; Sentencing for any crime of violence pursuant to C.R.S. 247 18 - 1.3 - 406; Sentencing for a felony crime enumerated in C.R.S. 247 24 - 4.1 - 302 (1); Sentencing for a felony offense in violation of C.R.S. 18 - 9 - 202; Sentencing for an offense classified as a class 1, 2, or 3 felony or a level 1 drug felony pursuant to any sectio n of Title 18 of the Colorado Revised Statutes; Sentencing for an offense in violation of Part 1 of Article 6 of Title 18 of the Colorado Revised Statutes; Sentencing for an offense in violation of: C.R.S. 247 18 - 3.5 - 103 (4), (5), (6), (7), (8), and (9); 18 - 5 - 902 (1); or 18 - 7 - 203. 10. Petitioner requests the Court to enter an order sealing criminal conviction records pertaining to the Defendant, pursuant to 247 24 - 72 - 70 6 , 247 24 - 72 - 707, or 247 24 - 72 - 708 C.R.S., as applicable . 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 Date CERTIFICATE OF SER VICE I certify that on (date) a true and accurate copy of this Motion to Seal Criminal Conviction Records was served on the Prosecuting Attorney by: Hand Delivery E - filed Faxed to this number or by placing it i n the United States mail, postage pre - paid, and addressed to the following: Signature of Defendant American LegalNet, Inc. www.FormsWorkFlow.com