Colorado Check List To Petition To Discontinue Sex Offender

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					Case Name _____________________ v. ______________________                      Case Number: _______________



                                    CHECK LIST
              FOR PETITION TO DISCONTINUE SEX OFFENDER REGISTRATION
To enable the Court to have the accurate information for the Petition to Discontinue Sex Offender Registration,
the Petitioner needs to provide the following names and addresses:

All Law Enforcement Agencies that you have registered with:

___________________________________________            ____________________________________________
Name of Agency                                         Name of Agency

___________________________________________            ____________________________________________
Address of Agency                                      Address of Agency

___________________________________________            ____________________________________________
City         State                 Zip Code            City         State                  Zip Code


___________________________________________            ____________________________________________
Name of Agency                                         Name of Agency

___________________________________________            ____________________________________________
Address of Agency                                      Address of Agency

___________________________________________            ____________________________________________
City         State             Zip Code                City         State                  Zip Code


Treatment Provider(s)

___________________________________________            ____________________________________________
Name of Treatment Provider                             Name of Treatment Provider

___________________________________________            ____________________________________________
Address of Treatment Provider                          Address of Treatment Provider

___________________________________________            ____________________________________________
City         State                  Zip Code           City         State                  Zip Code


Were you supervised by probation or the Division of Youth Corrections? If yes please list below.

___________________________________________            ____________________________________________
Probation Officer                                      Division of Youth Corrections

___________________________________________            ____________________________________________
Address                                                 Address

___________________________________________            ____________________________________________
City         State                  Zip Code           City         State                   Zip Code



            IF YOU NEED ADDITIONAL SPACE CONTINUE ON THE BACK OF THE FORM


JDF 460   R8/02   CHECK LIST