R evised May 1, 2019 Consent and Waiver of Hearing - Expungement Page 1 of 2 Name Address City, State, Zip Phone Check your email. You will receive information and documents at this email address. Email In the [ ] District [ ] Justice Court of Utah Judicial District County Court Address In Re: Petitioner C onsent and W aiver of H earing Expungement (Prosecutor) Case Number Judge The undersigned Petition to Expunge Records and the case file. [ ] to Expunge Records. [ ] The undersigned consents to this court entering an order for expungement. [ ] The case was dismissed without prejudice or without condition, but the prosecution has not filed and does not intend to refile related charges. [ ] There: [ ] is a victim in this case. [ ] is not a victim in this case. American LegalNet, Inc. www.FormsWorkFlow.com R evised May 1, 2019 Consent and Waiver of Hearing - Expungement Page 2 of 2 [ ] The victim has been notified of the Petition to Expunge Records. [ ] The victim has been notified and has authorized the undersigned to waive the order for expungement without further notice. Prosecutor (print name) Address City, State, Zip Phone American LegalNet, Inc. www.FormsWorkFlow.com