Request to Judge

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This form is available as a convenience to the defendant, and must be submitted timely to avoid possible penalties or sanctions. This form is to be filled out ONLY by a defendant with a case at the City of Orem Justice Court. Any form submitted without a current case number or incomplete information will not be considered.
Please fill out the line(s) that apply or use the Other line to specify your request. Also, please give a brief explanation of why you are making this request, and include any information that you feel is relevant for the judge and/or City Prosecutor to know in considering this request.
* Required Fields - You must fill out the fields with * symbols
Defendant Information
*Case # and Date of Birth    *Name
*Address
*Phone
*Your Email
I am Requesting:
An extension on my fine. I can pay the fine in full by
To Skip Payment.
To adjust my monthly payments to $ per month to begin .
To do community service in lieu of the fine balance.
An extension to complete evaluation or class.
  I can have completed by .
An extension on jail time. I would like to have until to complete the jail time.
Charge to be dismissed due to successful completion of terms of Plea in Abeyance agreement.
Probation to be terminated.
To continue my hearing currently scheduled for
Request bail money posted in the amount of $ be applied to the outstanding fines/fees in this case.
Request bail money posted be refunded to @
Brief Explanation (if needed)
2000 characters limit):

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