STATE OF MISSOURI



IN THE CIRCUIT COURT OF THE COUNTY OF FRANKLIN

STATE OF MISSOURI

«TableStart_Case»

|STATE OF MISSOURI, |) |

| Plaintiff, |) Cause No. |

| |) |

| VS |) Division No. |

| |) |

|«Ref_BookedFirstName» «Ref_BookedMiddleName» «Ref_BookedLastName»|) |

| Defendant. |) |

«TableEnd_Case»

AFFIDAVIT REQUESTING NON-PROSECUTION

«TableStart_Victims»

I, «Vctm_FirstName» «Vctm_MiddleName» «Vctm_LastName», do hereby swear and affirm as follows:

«TableEnd_Victims»

1) I am a complaining witness in the above-captioned matter.

2) I have requested that the Prosecuting Attorney of Franklin County, Missouri, no

longer pursue prosecution of the defendant, «TableStart_Case» «Ref_BookedFirstName» «Ref_BookedMiddleName» «Ref_BookedLastName», in the above-captioned matter.«TableEnd_Case»

________________________________

«TableStart_Victims»«Vctm_FirstName» «Vctm_MiddleName» «Vctm_LastName»

«TableEnd_Victims»

Subscribed and sworn before me this _______ day of __________________________, 2010.

_________________________________

NOTARY PUBLIC

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