Form Ldf 229 - Notice Of Intent To Pursue Collection By Victim
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1County Court
District Court
Denver Juvenile Court
_____________________________County, Colorado
Court Address:
State of Colorado
v
COURT USE ONLY
Defendant: _____________________________
Attorney or Party Without Attorney (Name and Address):
Case Number
Phone Number:
E-mail:
FAX Number:
Atty. Reg. #:
Division
Courtroom
NOTICE OF INTENT TO PURSUE COLLECTION BY VICTIM
Pursuant to §16-18.5-107, C.R.S., as amended, the below named person(s) or entity hereby puts on notice the
Court, the Collections Investigator, and the Department of Corrections, if Defendant was sentenced thereto, of his
or her intent to pursue collection of restitution in his or her own name. It is further stated and understood that:
1.
The below named person is a victim in whose name a restitution order has been entered by this Court.
2.
That such order was entered on ______________________________ (date of order).
3.
That the amount of outstanding restitution still owed to this victim as shown by the court’s record is
$_______________.
4.
That the below named person wishes to exercise his or her right to pursue collection of restitution in his or her
own name pursuant to §16-18.5-107, C.R.S. as amended.
5.
That the Court, the Collections Investigator, and/or the Department of Corrections shall cease all attempts to
collect the restitution due to the person named in this notice, except that the Collection Investigator may still
assist the victim in his or her efforts.
6.
That this Notice of Intent to Pursue Collection by Victim was delivered to the Clerk of the Court or, if the
Defendant was sentenced to the Department of Corrections, to the Executive Director of the Department of
Corrections on ________________________ (date delivered).
Dated: ________________________ (today’s date)
_____________________________________
Signature of Victim
______________________________________
Type/Print Name of Victim
Note: Address/Telephone number is optional.
Address: ______________________________
City: _____________________ State: ______
Telephone: ____________________________
Subscribed and affirmed, or sworn to before me in the County of ________________________, State of
____________________, this _______, day of ________________, 20 _____.
My Commission Expires: ___________________
______________________________________
Notary Public/Deputy Clerk
JDF 229 R7/06
NOTICE OF INTENT TO PURSUE COLLECTION BY VICTIM
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