Sixth District Court

Paper Travel Slip and
Order
(use only in criminal or traffic case types)

(cid:57) Garfield
(cid:57) Kane
(cid:57) Piute

(cid:57) Sanpete
(cid:57) Sevier
(cid:57) Wayne

Part 1.  The Court has received the attached request from or

G 4.3 Adjust payment terms.

about a defendant in a criminal or traffic case. 

Author:

Case #

____________, 20__

X

Clerk’s initials

G

G

G

Suspend fine balance by ___ % or $

Suspend  restitution balance by ___ % or $

Change the due date for the next payment

Advance it _______________

G 4.4 Change the court records. Give notice to the parties and

to the Utah Bureau of Criminal Identification (BCI).

Part 2. To the county attorney: Please review and respond,

then return all papers to me.

From

to

____________, 20__

X

Part 3. Response.

Change

Count 1

Count 2

G 4.5 Other:

paper_travel_slip060420099

erson being released from jail

 ___________, 20__

erson picking up at the jail

X P

X P

Judge

 ___________, 20__

X

art 5. Signatures

  P

I promise to obey this order

 ___________, 20__

Part 6. Copy to 

Address

Date

Initials

____________, 20__

X

Part 4. Judge’s Order.

G 4.1 No changes will be made to the current status.

G 4.2 Release the defendant from jail .

Date:

G If

Time

appears and asks for the defendant

Return to jail

Date

Time

Must be with

Must be at



Paper Travel Slip and Order

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