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STATE OF NORTH DAKOTA IN DISTRICT COURT COUNTY OF … Resources/Legal Self Help... · ndlshc 1 aff...

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NDLSHC Page 1 of 3 Affidavit Prohibit Pub Access/Rev Jan 2020 (Paragraph 5 continues on next page.) STATE OF NORTH DAKOTA IN DISTRICT COURT COUNTY OF _________________________ ____________________ JUDICIAL DISTRICT THE STATE OF NORTH DAKOTA ) PLAINTIFF, ) Criminal Case No. _____________________ ) vs. ) ) AFFIDAVIT IN SUPPORT OF MOTION TO ____________________________ ) PROHIBIT PUBLIC ACCESS DEFENDANT. ) I, ___________________________________________________________________, the undersigned, state as follows: 1. I am the defendant in the above-captioned criminal case(s). 2. I was charged on ______________________________________________________ with ______________________________________________________________________________ _____________________________________________________________________________. 3. On _______________________________________________________, the charge(s) against me was/were dismissed / I was acquitted of the charge(s). 4. In the above-captioned criminal case(s), the reason for dismissal of charge(s) / acquittal was ________________________________________________________________ ______________________________________________________________________________ _____________________________________________________________________________. 5. Because the records have remained available for public access, I have sustained or am likely to sustain the following harms: _______________________________________________ ______________________________________________________________________________ ______________________________________________________________________________
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Page 1: STATE OF NORTH DAKOTA IN DISTRICT COURT COUNTY OF … Resources/Legal Self Help... · ndlshc 1 aff prohibit pub access/jun 2016. state of north dakota in district court . county of

NDLSHC Page 1 of 3 Affidavit Prohibit Pub Access/Rev Jan 2020

(Paragraph 5 continues on next page.)

STATE OF NORTH DAKOTA IN DISTRICT COURT

COUNTY OF _________________________ ____________________ JUDICIAL DISTRICT

THE STATE OF NORTH DAKOTA ) PLAINTIFF, ) Criminal Case No. _____________________ ) vs. ) ) AFFIDAVIT IN SUPPORT OF MOTION TO ____________________________ ) PROHIBIT PUBLIC ACCESS DEFENDANT. )

I, ___________________________________________________________________, the

undersigned, state as follows:

1. I am the defendant in the above-captioned criminal case(s).

2. I was charged on ______________________________________________________ with

______________________________________________________________________________

_____________________________________________________________________________.

3. On _______________________________________________________, the charge(s)

against me was/were dismissed / I was acquitted of the charge(s).

4. In the above-captioned criminal case(s), the reason for dismissal of charge(s) /

acquittal was ________________________________________________________________

______________________________________________________________________________

_____________________________________________________________________________.

5. Because the records have remained available for public access, I have sustained or am

likely to sustain the following harms: _______________________________________________

______________________________________________________________________________

______________________________________________________________________________

Page 2: STATE OF NORTH DAKOTA IN DISTRICT COURT COUNTY OF … Resources/Legal Self Help... · ndlshc 1 aff prohibit pub access/jun 2016. state of north dakota in district court . county of

NDLSHC Page 2 of 3 Affidavit Prohibit Pub Access/Rev Jan 2020

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Additional sheets are attached as Exhibit B.

Page 3: STATE OF NORTH DAKOTA IN DISTRICT COURT COUNTY OF … Resources/Legal Self Help... · ndlshc 1 aff prohibit pub access/jun 2016. state of north dakota in district court . county of

NDLSHC Page 3 of 3 Affidavit Prohibit Pub Access/Rev Jan 2020

6. I declare, under penalty of perjury under the law of North Dakota, that everything I

stated in this Affidavit is true and correct.

STATE OF ) ) COUNTY OF _________________________ ) ss. ) COUNTRY OF _________________________ ) Signed on this _____ day of ___________________________, 20______.

________________________________________________ Defendant Signature

Printed Name

Address

City, State, Zip Code

Telephone Number


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