In the Superior Court of the State of Delaware Civil Action No.: Petitioner v. (Leave Blank - Court Will Assign) State of Delaware Respondent Petition for Expungement of Criminal Record Pursuant to 11 Del. C. § 4374 (Current Name) hereby petitions this Honorable Court for expungement of his/her criminal record. In support of this Petition, Petitioner declares that: 1. 2. 3. 4. 5. Full Name at Time of Arrest: Current Address: Date of Birth: Telephone Number: Date(s) of Arrest: Petitioner was arrested by the: Delaware State Police Troop No. Bethany Beach PD Blades PD Bridgeville PD Dagsboro PD Delmar PD Dewey Beach PD Ellendale PD Fenwick Island PD Frankford PD Georgetown PD Other (Name of Arresting Agency) * PD ­ Police Department Greenwood PD Laurel PD Lewes PD Milford PD Millsboro PD Millville PD Ocean View PD Rehoboth Beach PD Seaford PD Selbyville PD American LegalNet, Inc. www.FormsWorkFlow.com SC Revised 03/21/2017 6. List Each Charge Separately (if applicable continue to list any additional charges on the last page) Charge Disposition Court of Record Case ID Number 7. 8. The Petitioner has prior criminal record: YES NO The continued existence and possible dissemination of information relating to the arrest of Petitioner causes, or may cause, circumstances which constitute a manifest injustice to Petitioner. You must explain how the Petitioner is negatively affected by the continued existence of the record: WHEREFORE, Petitioner prays that this Court enter an order directing: A. That all indicia of arrest contained in the police records and the Court records relating to the previously mentioned charges be expunged and removed from the files and placed in the control of the supervisor of the State Bureau of Identification as provided for in 11 Del. C. §4374 (f). That certified copies of this Court's Order be delivered to the Petitioner, the Delaware Department of Justice, and the State Bureau of Identification, pursuant to 11 Del. C. §4374 (f). B. C. That the Department of Justice and the Prothonotary of the Superior Court of the State of Delaware take appropriate steps to see that all records not destroyed pursuant to this Order be handled in such a manner as to insure that such records not be open to public inspection, or disclosure. D. That it shall not be necessary for the Petitioner to disclose his/her arrest on the above mentioned charges for any reason. Petitioner or Petitioner's Attorney Sworn to and Subscribed before me this day of , 20 Notary Public (Signature) American LegalNet, Inc. www.FormsWorkFlow.com SC Revised 03/21/2017 In the Superior Court of the State of Delaware Civil Action No.: Petitioner v. (Leave Blank - Court Will Assign) Expungement Order State of Delaware Respondent AND NOW, TO WIT, it appearing that Petitioner: 1. 2. 3. 4. 5. Full Name at Time of Arrest: Current Address: Date of Birth: SBI Number: Date(s) of Arrest: it appearing that the Petitioner now seeks to have all indicia of arrest on the below charge(s) expunged; (List Each Charge Separately and (if applicable continue to list any additional charges on the last page) Case ID Number Charge Disposition Court of Record and it appearing that the Attorney General has been served with the Petition herein, and that the Attorney General has no opposition thereto; IT IS SO ORDERED A. That all indicia of arrest contained in the police records and the Court records relating to the abovementioned charge(s) be expunged and removed from the files and placed in the control of the supervisor of the State Bureau of Identification as provided for in 11 Del. C. 4374 (f). That certified copies of this Court's Order be delivered to the Petitioner or Petitioner's Attorney, the Delaware Department of Justice, and State Bureau of Identification, pursuant to 11 Del. C. §4374 (f). That the Department of Justice and the Prothonotary for the Superior Court of the State of Delaware take appropriate steps to see that all records not destroyed pursuant to this Order be handled in such a manner as to insure that they not be opened to public inspection or disclosure. That it shall not be necessary for the Petitioner to disclose his/her arrest on the above mentioned charges for any reason. B. C. D. Date Judicial Officer Signature American LegalNet, Inc. www.FormsWorkFlow.com SC Revised 03/21/2017 If applicable, List Any Additional Charges Below: The charges listed below are a continuation of the Petitioner's response to question number 6 of the Petition for Expungement of Criminal Record that this form is attached to: Case ID Number Charge Disposition Court of Record American LegalNet, Inc. www.FormsWorkFlow.com SC Revised 03/21/2017