The State of Michigan THE PEOPLE OF þ en-US en-US en-USven-USDefendant/Juvenile name, address, and telephone no.en-USCTN/TCNen-USSIDen-USDOB en-US Juvenile In the matter of en-US en-USCounten-USCRIMEen-USCHARGE CODE(S)en-USMCL citation/PACC Codeen-USUSE NOTE: This form is for use when the arresting agency or the Michigan State Police has failed to destroy the biometric data and arrest record as required en-USby law or when the Michigan State Police has not destroyed the biometric data and arrest record because the defendant has had a prior conviction as stated in en-USMCL 28.243(12)(h). This form is not for use in conjunction with setting aside an adjudication pursuant to MCL 712A.18e or setting aside a conviction pursuant en-USto MCL 780.621. 1. þ I, en-USName (type or print)en-US , state that on en-USDate þ þ I was found not guilty of all offense(s) charged in this case, and the arresting agency and/or Michigan State Police has þ not destroyed the biometric data and arrest record as required by law. þ þ I was found not to be within the provisions of MCL 712A.2. þ þ The charges in this case were dismissed by nolle prosequi before trial, and the arresting agency and/or Michigan State þ þ Police has not destroyed the biometric data and arrest record as required by law. 2. þ This motion does not pertain to any sentence imposed under MCL 333.7411, MCL 600.1076(4), MCL 762.11-MCL 762.15, þ MCL 769.4a, MCL 750.350a, MCL 750.430, or to one of the crimes listed in MCL 28.243(14). 3. þ en-USI REQUESTen-US that my biometric data and arrest record be destroyed by the arresting agency and/or Michigan State Police. en-USDate þ en-USSignatureen-USA hearing will be held on this motion on en-USDateen-US at en-USTimeen-USat en-USLocationen-US before Hon. en-USBar no.en-US .en-USI certify that on this date I served a copy of this motion and notice of hearing on the parties or their attorneys by first-class mailen-USaddressed to their last-known addresses as defined by MCR 2.107(C)(3). en-USDate þ en-USSignatureen-USMOTION en-USNOTICE OF HEARING en-USCERTIFICATE OF MAILING American LegalNet, Inc. www.FormsWorkFlow.com