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Record Restricton Form
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Expungement Form

Enter arrest information below to apply for restricton of charges from one court case. The system processes one court case per application.

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Any other name that might be used on your record ?

Date Of Birth

Race

Gender

Social Security Number

Phone

Email

Send Account Verification Code

Minimum 12 characters, at least one uppercase ,one lowercase letter, one number and one special character

Address 1

Address 2

Country

State

City

Post Code

Arresting Agency

Date of Arrest

Driver’s License Number

 

OR

State Identification Number

Issuing state

Case Number

Offense(s) Arrested For

You will receive an email to the email address provided once your application is received. The District Attorney's Office will contact you once your application is processed or if additional information is needed.

Please ensure all information above is correct
before submitting form.

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Confirm Your Expungement Form


Arresting Date:
Charge:
$199
Arresting Agency:
First Name:
Last Name:
Address:
City/State/Zip:
Phone Number:
Amount Due
$ 199
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Card Information

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Thank You

Your application has been successfully submitted

We will now consider your ENTIRE record for possible restricton

You do not need to resubmit the application if you have additional charges.

Thank you in advance for your patience

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