(Rev. 12.20.18) PETITIONER'S SIGNATURE PETITION FOR EXPUNGEMENT G.L. c. 276, 247 100K DOCKET NO. Trial Court of Massachusetts YOUR NAME AND ADDRESS COURT DEPARTMENT Boston Municipal Court District Court Juvenile Court Superior Court COURT DIVISION I request that this Court order that the records of the following charges be expunged (list charges): I make this request because the records were created as a result of: False use of my identification Unauthorized use of my identity Theft of my identity The offense(s) described above is/are no longer a crime Errors by law enforcement Errors by civilian or expert witness(es) Errors by Court employees Fraud perpetrated upon the Court Specifically (provide as much detail as possible explaining the reasons for your request): If you need more space to explain, check this box and continue in the space provided on the back of this sheet. You may If you have documents that support your petition, check this box and attach them to this petition. I request that the Court hold a hearing on my petition. I provided this petition and supporting documents to the District Attorney's Office of the county that prosecuted the case by delivering a copy in hand OR by mailing a copy via first class mail to the District Attorney's OfficeI swear under the pains and penalty of perjury that all information I provided in this Petition is true to the best of my knowledge and belief. DATE:also attach additional pages if necessary. Please see reverse side for instructions and space for additional information. I request the assistance of an interpreter for the following language: (There is no charge to you for interpreter or translation services) dateon . American LegalNet, Inc. www.FormsWorkFlow.com (Rev. 12.20.18) Additional Information: INSTRUCTIONS TO PETITIONER: Reasons for Expunging a Record Under G.L. c. 276, 247 100K Under chapter 276, 247 100K, you can directly ask a judge to permanently destroy, or 223expunge224, the official court records that were created because of one of the following reasons: (i) false use of your identification; (ii) unauthorized use of your identity; (iii) theft of your identity; (iv) an offense that is no longer a crime; (v) demonstrable errors by law enforcement; (vi) demonstrable errors by civilian or expert witnesses; (vii) errors by a court employee; or (viii) demonstrable fraud perpetrated upon the court. Under this law, the judge can order expungement of the court record only if he or she determines on clear and convincing evidence that the record was created because of one of the reasons above and that expungement of the record would be in the interests of justice. Expungement may also be available in circumstances other than those listed above. If you want to seek expungement under one of these other circumstances, you must fill out a different petition and submit it to the Office of the Commissioner of Probation. You can find information about these other provisions, including eligibility requirements, at www.mass.gov. What You Must Show You must demonstrate to the judge that the court record was created because of one of the reasons above and that expunging the record would be in the interests of justice. When you fill out this petition, you should provide as much detail as possible. You may give the judge copies of documents that support your reasons for asking for expungement. On the petition, there is a box to check for a hearing. At a hearing, you can tell the judge why your petition fits under one of the reasons above, and why granting the petition would be in the interests of justice. Multiple Charges On this petition, you should include all of the charges connected to the case that you are asking the judge to expunge. If you would like to ask a judge to expunge records in different cases, you should file separate petitions for each case. Where to File the Petition You should file this petition in the clerk's office in the court where the case was heard. Providing a Copy of the Petition to the District Attorney's Office You must provide a copy of this petition and any documents that you file with the petition to the District Attorney's Office that prosecuted the case on or before the day that this petition is filed in the court. You can do this by bringing a copy to the District Attorney's Office or by mailing a copy to the District Attorney's Office by first class mail. Records will be Permanently Destroyed An order of expungement requires the clerk of the court where the record was created to destroy/permanently erase the trial court records within the care, custody or control of the clerk's office, probation, and the Department of Criminal Justice Information, except for information contained in the domestic violence record keeping system. It also requires criminal justice agencies to destroy/permanently erase the record from all publicly available police logs maintained pursuant to G.L. c. 41, 247 98F within their care, custody or control. Further, criminal justice agencies are required to respond to inquiries from any party, including criminal justice agencies, a county agency, a municipal agency or state agency that no record exists. While the clerk will provide you with a copy of the expungement order, if you want copies of the records, any documents that you filed, or the petition, you must make copies before the court orders expungement. Once the record is destroyed, you will not be able to get a copy from the court. American LegalNet, Inc. www.FormsWorkFlow.com