Event Code: 6154 IN THE CIRCUIT COURT, EIGHTEENTH JUDICIAL CIRCUIT, BREVARD COUNTY, FLORIDA IN THE COUNTY COURT, BREVARD COUNTY, FLORIDA DIVISION CIVIL AFFIDAVIT FOR EXPUNGEMENT CRIMINAL JUVENILE OF CRIMINAL HISTORY RECORD TRAFFIC CASE NUMBER 05 - - - - _XXX-XX CLOCK IN PLAINTIFF STATE OF FLORIDA vs. DEFENDANT/PETITIONER I, _________________________________________, am the Defendant in the above-styled cause and I do hereby sw ear and affirm that: 1. I fully understand the meaning of all the terms of this affidavit. 2. I have never been adjudicated guilty of a criminal offense or a comparable ordinance violation. 3. I w as arrested on the __________ day of ____________________, 20_____, by ___________________________, and I have not been adjudicated guilty of the charges stemming from that arrest or alleged criminal activity surrounding my arrest. 4. I am eligible for the relief requested, to the best of my know ledge and belief, and do not have any other petition to expunge or seal pending before any court. 5. I have never secured a prior records expunction or sealing under any law . 6. My record of arrest for this date has been sealed for at least ten (10) years; or an indictment or information w as not filed against me for the above criminal transaction; or an indictment or information filed against me w as dismissed by the prosecutor or the court. Defendant/Petitioner STATE OF FLORIDA, COUNTY OF BREVARD Sw orn to and subscribed before me this _________ day of ______________________________, 20_____. NOTARY PUBLIC, or other person authorized to administer an oath. (Print, type or stamp commissioned name of Notary Public) Personally know n ___________ or produced identification __________. Type of identification produced__________________________________ . LAW 348 Rev. 02/2007 BAR CODE LABEL American LegalNet, Inc. www.FormsWorkflow.com Page 1 of 2 Event Code: 6151 IN THE CIRCUIT COURT, EIGHTEENTH JUDICIAL CIRCUIT, BREVARD COUNTY, FLORIDA IN THE COUNTY COURT, BREVARD COUNTY, FLORIDA DIVISION CIVIL CRIMINAL JUVENILE TRAFFIC CASE NUMBER 05 - - - - _XXX-XX CLOCK IN MOTION TO EXPUNGE CRIMINAL HISTORY RECORD PLAINTIFF STATE OF FLORIDA vs. DEFENDANT/PETITIONER The petitioner, __________________________________________, by and through the undersigned attorney, petitions this honorable court, pursuant to Florida Rules of Criminal Procedure 3.692, and section 943.0585 or section 943.59 Florida Statutes, to expunge all criminal history record information in the custody of any criminal justice agency and the official records of the court, concerning the petitioner' s arrest on the ________ day of __________________________, 20_____, by________________________________________________(arresting agency), and charged w ith________________________________________________________________________________________________ (charges), and as grounds therefore show s: 1. On the _________ day of ____________________, 20____, the petitioner,____________________________, a _____________(race/sex), w hose date of birth is _________________________(date of birth), w as arrested by __________________________________(arresting agency), and charged w ith________________________________ _____________________________________________________________________________________________(charges). 2. The petitioner has not been adjudicted guilty of any of the charges stemming from this arrest or alleged criminal activity. 3. The petitioner has not been previously adjudicated guilt y of a criminal offense or a comparable ordinance violation. 4. The petitioner has not secured a prior records expunction or sealing under Section 943.0585, or 943.059, Florida Statutes, former section 943.058, Florida Statutes, former section 893.14, Florida Statutes, or former section 901.33, Florida Statutes, or any other law , rule, or authority. 5. Such record has been sealed under section 943.059, Florida Statutes, former section 943.058, Florida Statutes, former section 893.14, Florida Statute, or former section 901.33, Florida Statutes, for at least (10) years; or there has not been an indictment or inf ormation filed against the petitioner w ho is the subject of this criminal history record information; or an indictment or information filed against the petitioner w ho is the subject of this criminal history information w as dismissed by the prosecutor or the court. LAW 349 Rev. 03/2007 BAR CODE LABEL American LegalNet, Inc. www.FormsWorkflow.com Page 2 of 2 DEFENDANT MOTION TO EXPUNGE CRIMINAL HISTORY RECORD CASE NUMBER 05 - - - - _XXX-XX WHEREFORE, the petitioner, ____________________________________________, moves to expunge any criminal history record information and any official court records regarding his/her arrest by ______________________________ _____________________ (arresting agency), for __________________________________________________________________ ___________________________________________ (charges), on the _________day of _______________________, 20 _____. I HEREBY CERTIFY that a true and correct copy of the foregoing pleading has been served on_____________ ____________________________(name of prosecuting authority), State Attorney for the _____________ Judicial Circuit, in and for ____________________ County; _____________________________________________________ (arresting agency); ________________________________________________ (Sheriff of county w here defendant w as arrested, if different); this _______ day of _____________________, 20 ________. SIGNATURE Name: Address: City/State/Zip: Telephone Number: FL Bar No: LAW 349 Rev. 03/2007 American LegalNet, Inc. www.FormsWorkflow.com Event Code: 6724 CASE NUMBER IN THE CIRCUIT COURT, EIGHTEENTH JUDICIAL CIRCUIT, BREVARD COUNTY, FLORIDA IN THE COUNTY COURT, BREVARD COUNTY, FLORIDA 05 - DIVISION - - - XXXX-XX CLOCK IN CRIMINAL JUVENILE TRAFFIC NOTICE OF HEARING PLAINTIFF STATE OF FLORIDA vs. DEFENDANT HEARING INFORMATION DATE TIME LOCATION JUDGE RE: State Attorney' s Office Sealing and Expungement Section 2725 Judge Fran Jamieson Way Viera, Florida 32940 TO: YOU ARE HEREBY NOTIFIED that a hearing w ill be held at the date, time, and location indicated above. If you are a person w ith disability w ho needs any accommodation in order to participate in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact Court Administration at 2825 Judge Fran Jamieson Way, 3rd Floor, Melbourne, FL 32940, 321-633-2171, w ithin 2 w orking days of your receipt of this notice. If you are hearing or voice impaired, call 1-800-955-8771. For other information, please call 321-637-5413. I HEREBY CERTIFY that a true copy of the foregoing Notice of Hearing has been mailed to the State Attorney' s Office, Sealing and Expungement Section, 2725 Judge Fran Jamieson Way, Viera, Florida 32940 DEFENDANT' S SIGNATURE ADDRESS CITY STATE ZIP TELEPHONE NUMBER PRINT DEFENDANT' S NAME DATE CLERK OF COURTS LAW 870 New 05/2007 BY DC BAR CODE LABEL American LegalNet, Inc. www.FormsWorkflow.com Event Code: 6159 IN THE CIRCUIT COURT, EIGHTEENTH JUDICIAL CIRCUIT, BREVARD COUNTY, FLORIDA IN THE COUNTY COURT, BREVARD COUNTY, FLORIDA DIVISION CIVIL CRIMINAL JUVENILE TRAFFIC ORDER TO EXPUNGE UNDER SECTION 943.0585, F.S. AND FLORIDA RULE OF CRIMINAL PROCEDURE 3.692 CASE NUMBER - - - - XXX-XX CLOCK IN PLAINTIFF STATE OF FLORIDA vs DEFENDANT/PETITIONER THIS CAUSE having come on to be heard before me this date upon a petition to expunge certain records of the petitioner' s arrest on the ________ day of _________________________, 20 _____, by___________________________________________ (arresting agency), and charged w ith______________________________________________________________________________________ ___________________________________ (charges), and the court having heard argument of counsel and being otherw ise f ully advised in the premises, the court hereby finds the follow ing: 1. The petitioner has never previously been adjudicated guilty of a criminal offense or a comparable ordinance violation nor adjudicated delinquent for committing a felony or a misdemeanor specified in Section 943.051(3)(b), F.S. 2. The petitioner w as not adjudicated guilty of nor adjudicated delinquent for committing any of the acts stemming from the arrest of criminal activity to w hich this expunction petition pertains. 3. The petitioner has not secured a prior records expunction or sealing. 4. This record has either been sealed for at least 10 years; or no indictment, information, or other charging document w as ever filed in this case against the petitioner; or an indictment, information, or other charging document filed against the defendant w as dismissed by the prosecutor of the court. 5. A Certificate of Eligibility issued by the Florida Department of Law Enforcement accompanied the petition for expunction of nonjudicial criminal history records. Whereupon it is ORDERED AND ADJUDGED that the petition to expunge is granted. All court records pertaining to the above-styled case shall be sealed in accordance w ith the procedures set forth in Florida Rule of Criminal Procedure 3.692; and it is further ORDERED AND ADJUDGED that the Clerk of this court shall forw ard a certified copy of this order to the State Attorney Special Prosecutor Statew ide Prosecutor Arresting Agency and the Sheriff of ____________________ County, w ho w ill comply w ith the procedures set forth in Section 943.0585, Florida Statutes, and appropriate regulations of the Florida Department of Law Enforcement, and w ho w ill further forw ard a copy of this order t o any agency that their records reflect has received the instant criminal history record information; and it is further ORDER AND ADJUDGED that ________________________________________ (arresting agency) shall expunge all information concerning indicia of arrest or criminal history record inf ormation regarding the arrest or alleged criminal activity to w hich this petition pertains in accordance w ith the procedures set forth in section 943.0585, Florida Statutes, and Florida Rule of Criminal Procedure 3.692. All costs of certified copies involved herein are to be borne by the _________________________________________________. DONE AND ORDERED BREVARD COUNTY, FLORIDA LAW 827 Rev. 02/2007 DATE JUDGE BAR CODE LABEL American LegalNet, Inc. www.FormsWorkflow.com