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In the [ ] District [ ] Justice Court of Utah

__________ Judicial District ________________ County

Court Address ______________________________________________________

_____________________________________
Petitioner

Order on Petition to Expunge
Records with Special Certificate

_______________________________
Case Number

_______________________________
Judge

The matter before the court is a Petition to Expunge Records. This matter is being
resolved by:

[ ] The pleadings and other papers of the parties, or

[ ] A hearing held on __________________________ (date), notice of which was

served on all parties and at which the court considered the pleadings and evidence
presented by the parties.

Having considered the documents filed with the court, the evidence, and the arguments,
and now being fully informed,

The Court Finds by Clear and Convincing Evidence that:

The petition is sufficient.

The statutory requirements have been met.

Expunging the petitioner’s records will not harm the interests of the public.

1021EXF Approved April 11, 2022 Order on Petition to Expunge Records with Special Certificate

Page 1 of 2

Name

Address

City, State, Zip

Phone

n Re:

The Court Concludes:

All records of petitioner’s arrest, investigation, and detention relating to: (choose
one)

[ ] the following incidents: _____________________; (law enforcement agency file

number) of _________________________________________________

(law enforcement agency name) should be expunged.

[ ] case number: _________________________ should be expunged. The

Court

The Court Orders:

All records of petitioner’s arrest, investigation, detention relating to:

[ ] the following incidents: _____________________; (law enforcement agency file

number) of _________________________________________________

(law enforcement agency name) will be expunged.

[ ] case number: _________________________ will be expunged.

• Petitioner may deliver a copy of this order to any government agency or

official that may have such records.

• The Bureau of Criminal Identification must notify all criminal justice agencies

affected by this order.

Rule 4-205.

• The clerk of the court must expunge all related court records as provided by

• Any other government agency or official receiving this order must expunge
related records as provided by Utah Code, Title 77, Chapter 40a, Part 4.

• Any government agency or official receiving this order may not divulge

information identifying the petitioner.

• Any government agency or official receiving this order must respond to any

inquiry as though the arrest or conviction did not occur.

Judge’s signature may instead appear at the top of the first page of this document.

Date

Signature ►

Judge

1021EXF Approved April 11, 2022 Order on Petition to Expunge Records with Special Certificate

Page 2 of 2

Order on Petition to Expunge Records with Special Certificate

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Utah state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from legacy.utcourts.gov (2023-03)
Page(s): 2
Fields(s): 87
Average fields per page: 43
Reading Level: Grade 15
LIST Grouping(s): GO-00-00-00-00.

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Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Order on Petition to Expunge Records with Special Certificate

About This Form:

Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02