IN THE CIRCUIT COURT OF THE ELEVENTH JUDICIAL CIRCUIT IN AND FOR MIAMI-DADE COUNTY, FLORIDA. 472 IN THE COUNTY COURT IN AND FOR MIAMI-DADE COUNTY, FLORIDA. DIVISION CASE NUMBER CRIMINAL PETITION TO EXPUNGE JUVENILE TRAFFIC/MISDEMEAN OR THE STATE OF FLORIDA CLOCK IN VS. PLAINTIFF DEFENDANT The petitioner, by and through the undersigned attorney, petitions this honorable court, pursuant to Florida Rule of Criminal Procedure 3.692 and section 943.0585, 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), for ________________________________________________________ (charges) , and as grounds therefor shows: 1. On the _____ day of _______________________, 20____, the petitioner, ______________________________ , a _____ (race)/ ____ (sex), whose date of birth is ______________________ , was arrested by ________________________ and charged with ______________________________________________________________________________________________________. 2. The petitioner has not been previously adjudicated guilty of any of the charges stemming from this arrest or alleged criminal activity. 3. The petitioner has not been previously adjudicated guilty 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 Statutes, or former section 901.33, Florida Statutes, for at least 10 years; or there has not been an indictment or information filed against the petitioner who is the subject of this criminal history information; or an indictment or information filed against the petitioner who is the subject of this criminal history information was dismissed by the prosecutor or the court. 6. The Petitioner has applied for and been issued a Certificate of Eligibility, Number _____________, by the Florida Department of Law Enforcement. WHEREFORE, the petitioner moves to expunge any criminal history record information and any official court records regarding his/her arrest by _____________________________________________ (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 KATHERINE FERNANDEZ RUNDLE, State Attorney for the 11th Judicial Circuit, in and for Dade County, 1350 Northwest 12 Avenue, Miami, FL 33136: ___________________________________________________________________(arresting agency); and the Miami-Dade Police Department, Records Section, 9105 Northwest 25 Street, Miami, FL, 33172, this__________ day of ______________________, 20_______. __________________________________________ Signature ___________________________________________ Print Name Address:___________________________________________ City-State_____________________ ( ) Telephone Number:__________________________________ Fla. Bar No. :___________________ CLK/CT 24 Rev. 1/06 Clerk's web address: www.miami-dadeclerk.com American LegalNet, Inc. www.FormsWorkflow.com