1. I am a defendant who has been issued a citation to appear in the Laramie Municipal Court for the charge(s) that I am requesting to be dismissed.
2. I am not being represented by an attorney regarding the charge(s) filed against me.
3. If I later obtain an attorney to represent me on my citation(s), I will not contact the City of Laramie Attorney’s Office and will only act through my attorney.
4. All information and documentation I provided to support my request for dismissal of the charge(s) is true and accurate.
5. I authorize the City of Laramie Attorney’s Office and any other law enforcement agencies to investigate the information and documentation I provided. I also authorize any other person to provide any information (including confidential or privileged information) related to this request, and agree to hold any other person harmless for the provision of such information.
6. I understand that requesting dismissal of the charge(s) does not create an attorney-client relationship between the City of Laramie Attorney’s Office and me and that I should have no expectations of this office other than those imposed by law.
7. I understand that I am waiving my rights to remain silent and to be represented by an attorney regarding the information and documentation I provide and that such may be used against me in court.