State of Alabama Unified Judicial System Form CR-65 7/2016 IN THE CIRCUIT COURT OF PETITION FOR EXPUNGEMENT OF RECORDS (Section 15-27-1 et seq., Code of Alabama 1975) , ALABAMA (Name of County) Case No. (Assigned by Clerk) [ ] STATE OF ALABAMA [ ] MUNICIPALITY OF (Court of Jurisdiction of case to be expunged) v. (Defendant/Petitioner) PETITIONER (Last Name) (First Name) (Middle Name) (Address) (Phone Number) XXX ­ XX (Social Security Number, Last four digits only) (Email) CASE NUMBER TO BE EXPUNGED _________________________________ CHARGE TO BE EXPUNGED __________________________________________________________________________ (Only one offense per petition; Multi-count cases require multiple petitions) I, the above-named Defendant/Petitioner, was charged with the above-named offense which is: (Check ONLY one (1) of the five (5) options listed below; If none apply, charge is not eligible for expungement) [ [ [ [ [ ] a misdemeanor criminal offense, ] a violation, ] a traffic violation, ] a municipal ordinance violation, ] a non-violent felony, I hereby file this Petition with the Circuit Court to expunge records relating to the above charge because: (Check ONLY one (1) of the seven (7) options listed below; If none apply, charge is not eligible for expungement) [ [ [ [ ] The charge was dismissed with prejudice. ] The charge was no billed by a grand jury. ] I was found not guilty of the charge. ] (Non-felony only) The charge was dismissed without prejudice more than two years ago, was not refiled, and I have not been convicted of any other felony or misdemeanor crime, any violation, or any traffic violation, excluding minor traffic violations, during the previous two years. ] (Non-violent felony only) The charge was dismissed after successful completion of a drug court program, mental health court program, diversion program, veteran's court, or any court-approved deferred prosecution program. More than one year has passed from the successful completion of the program. ] (Non-violent felony only) The charge was dismissed without prejudice more than five years ago, was not refiled, and I have not been convicted of any other felony or misdemeanor crime, any violation, or any traffic violation, excluding minor traffic violations, during the previous five years. ] (Non-violent felony only) Ninety days have passed from the date of dismissal with prejudice, no-bill, acquittal, or nolle prosequi and the charge has not been refiled. American LegalNet, Inc. www.FormsWorkFlow.com [ [ [ State of Alabama Unified Judicial System Form CR-65 7/2016 Page 2. PETITION FOR EXPUNGEMENT OF RECORDS (Section 15-27-1 et seq., Code of Alabama 1975) Case No. Attached to this Petition is: (Petition must include either item 1 or item 2; All Petitions must include item 3.) [ ] (1) a certified record of arrest from the appropriate agency for the court record I seek to have expunged, [ ] (2) a certified record of disposition, or a certified record of the case action summary from the appropriate court for the court record I seek to have expunged; [ ] (3) a certified official criminal record obtained from the Alabama Law Enforcement Agency (ALEA), I am providing the following additional information as required by Ala. Code 1975, § 15-27-1 et seq.: (Petitioner must specify each of the following:) 1. Criminal charge from the record to be considered: 2. Grounds for, or reasons why you seek, expungement: 3. The agency or department that made the arrest: 4. Any agency or department where the Petitioner was booked or was incarcerated or detained pursuant to the arrest or charge sought to be expunged: (There is no way for the Court to successfully expunge records that are not indicated in the Petition or held by entities not served. Therefore, if the Petitioner was not booked, incarcerated or detained pursuant to arrest on the above-listed charge, that must be indicated here.) Further, I have satisfied and paid in full all terms and conditions, including court ordered restitution, including interest, to any victim or the Alabama Crime Victims Compensation Commission, as well as court costs, fines, or statutory fees ordered by the sentencing court to have been paid, absent a finding of indigency by the court. American LegalNet, Inc. www.FormsWorkFlow.com State of Alabama Unified Judicial System Form CR-65 7/2016 Page 3. FOR EXPUNGEMENT OF RECORDS (Section 15-27-1 et seq., Code of Alabama 1975) Case No. I swear or affirm, under the penalty of perjury: (1) that the allegations I have made in this Petition are true and correct; (2) that I have satisfied the requirements set out in Ala. Code 1975, § 15-27-1 et seq. (3) (Select one of the following:) [ [ ] ] that I have not previously applied for an expungement in this or any other jurisdiction. that I have previously filed for an expungement. My previous expungement was filed in COUNTY and it was given case number .That previous petition for expungement was [ ] granted [ ] denied. Signature of Petitioner/Affiant [ ] pro se (Not represented by an attorney) Personally appeared before the undersigned, an officer duly authorized to administer oaths, , Petitioner named in the foregoing Petition, who being duly sworn, states that the facts set forth in the foregoing Petition are true and correct to the best of their information and belief. Sworn To And Subscribed Before Me This: Date Person Authorized to Administer Oaths or Notary Public Name of Attorney Bar No. Signature of Attorney Business Address of Attorney City State Zip Code Telephone Email Address American LegalNet, Inc. www.FormsWorkFlow.com State of Alabama Unified Judicial System Form CR-65 7/2016 Page 4. PETITION FOR EXPUNGEMENT OF RECORDS (Certificate of Service) (Section 15-27-1 et seq., Code of Alabama 1975) Case No. (This page is a form Certificate of Service that can be used by the petitioner to serve the statutorily required parties as well as any entities holding records the Petitioner wants expunged. A separate form should be completely filled out and signed by the person who actually served the party. Include as many copies of this page as necessary to show service on all required parties. NOTE: Records held by parties who are not served may not be successfully expunged, or expungement may be substantially delayed. Please understand, if you do not provide the name and address of any agency in possession of records you want expunged, the Court has no way of finding those records and successfully completing t