IN THE COMMON PLEAS COURT OF LUCAS COUNTY, OHIO State of Ohio Plaintiff Case No. Judge: __________________________ vs. PETITION FOR EXPUNGMENT OF RECORD OF CONVICTION (FELONY) ORC 2953.32(A) ) Defendant Name ( Address ( City, State, Zip ( Telephone ( Social Security No. ( Date of Birth ( Pro Se Defendant ) ) ) ) ) ) Name ( Now Comes the above named Defendant, ___________________, SSN: __________, pursuant to Ohio Revised Code Section 2953.32 (A) (2) and moves this court to seal all records of his/her conviction in the above captioned matter on (conviction date) ___________ for the offense of __ ___, in violation of ORC SECTION __________________, In support of said Petition, Defendant states that it has been more than three years since the date of his/her conviction, completion of any sentence or the termination of any probation; that he/she has paid all fines, court costs and restitution imposed by the Court; that he/she is an "Eligible Offender" (as defined in ORC section 2953.31[A] by having not been convicted of more than one felony, or more than two misdemeanors if they are not of the same offense, or more than one felony and one misdemeanor, in Ohio or any other jurisdiction; and that he/she does not currently have any criminal proceedings pending in Ohio or any other jurisdiction. WHEREFORE, Defendant prays that the Court grant his/her request and seal the record of his/her conviction in the above captioned matter. Respectfully submitted, ___________________ DEFENDANT'S NAME Pro Se Defendant American LegalNet, Inc. www.FormsWorkFlow.com