JV-595 Request to Seal Juvenile Records Probation stamps date here when form is received. This form can be used to petition the juvenile court to seal your juvenile records. More information about sealing is available on form JV-595-INFO, How to Ask the Court to Seal Your Records. Submit this form to the probation department in the last county where you were on juvenile probation or, if you were not on probation, in any county where you had contact with law enforcement or probation that did not result in a court case. Once the probation department receives the completed form, it will have 90 days to file a record-sealing petition with the court for you, or 180 days if you include agencies outside of this county. 1 My information: a. Name: b. AKA (nickname or other family name): Fill in your name: Fill in court name and street address: Superior Court of California, County of c. d. e. f. Address: City, state, zip: Area code and telephone number: Date of birth: Name: Fill in case number, if known: Case Number: g. E-mail address: 2 I had a case(s) that went to court. Case file number(s) (if known): The date probation was terminated (if known): I don't remember my case number and/or date. See attached. (If you need more space, you may attach a separate page.) 3 I had contact with law enforcement but did not go to court. Date(s) I had contact with law enforcement: Name(s) of law enforcement or other agency(ies): See attached. (If you need more space, you may attach a separate page.) 4 I understand that the probation department is responsible for requesting the juvenile court to seal the records of only those agencies in its records and those listed on page 2 of this form. I understand that after I file this document and pay any fees that are required (fees are required only for petitioners 26 years of age and older and may be waived), the probation department will have 90 days to conduct an investigation and file a record-sealing petition for me with the juvenile court. I also understand that some records may not be eligible for sealing. I am aware that form JV-595-INFO, How to Ask the Court to Seal Your Records, provides more information on this process. Judicial Council of California, www.courts.ca.gov New July 1, 2016, Optional Form Welfare and Institutions Code, § 781; Cal. Rules of Court, rule 5.830 Request to Seal Juvenile Records JV-595, Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: Your name: Note: When you file this form with the probation department, it will research your case history and attach a list of contacts and addresses of all agencies that it knows have records of the case(s) and contacts(s) you listed on page 1. If you have had contacts with law enforcement or another agency with a record of your offense and that entity may not have been reported to the probation department, please list it below, or that record may not be sealed. If your case was transferred from one county to another, your records in both counties will be sealed. If you have a probation record in more than one county and that record was not transferred, you may ask the court to seal that record as well. If the court does not seal that record, it will inform you that you need to file this form in that county. Contacts not included on this form may not be sealed. The court may seal only those records listed on the petition. 5 Include all contacts (with addresses) you had, before your 18th birthday, with the agencies below that might not be part of your probation records: Court: Probation Department: Sheriff's Department: Police Department: California Highway Patrol: Department of Motor Vehicles: Law Enforcement: School(s): Homeland Security: Other: See attached. (If you need more space, you may attach a separate page or pages listing the contacts.) I declare that the information on this form is true and correct to the best of my knowledge. Date: Type or print your name Sign your name New July 1, 2016 Request to Seal Juvenile Records JV-595, Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com