Petition for Expungement Form

Petition for Expungement Form
Please fill out this form to petition for expungement of your criminal record.
Name
First NameLast Name
Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Case Number
Date of Conviction
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Court of Conviction
The Reason for Requesting Expungement
Supporting Documents
Please upload any supporting documents such as court records, character references, or other relevant evidence that supports your petition for expungement.
File Upload
Cancelof
Request for Judgement
I, First Name Last Name , am requesting an order expunging all records of my arrest, charges, and conviction in the above-referenced case, including but not limited to records held by the arresting agency, prosecutor’s office, and any other law enforcement or governmental agencies.

Respectfully submitted,
Name
First NameLast Name
Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
Clear
Should be Empty:

Supporting Documents