IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE COUNTY OF LINCOLN, 17TH JUDICIAL DISTRICT STATE OF OREGON, Plaintiff v. Defendant. ) ) ) ) ) ,) ) CASE # ORDER SETTING ASIDE CONVICTION AND RECORD OF ARREST THIS MATTER having come before the Court upon the motion of the Defendant for an Order Setting Aside the Conviction and Record of Arrest, pursuant to ORS 137.225, and the Court having reviewed the record and file herein, and now being fully advised, the Court hereby finds as follows: 1. That the defendant was arrested and convicted herein as follows: Original Arrest Date: Original Arrest Charge: Arresting Agency: Date of Conviction: Conviction Charge: Disposition: 2. That the positive identification of the defendant has been established as follows: FBI Identification Number: Oregon State Certification Number: Arresting Agency Number: 3. That the circumstances and behavior of the defendant since the date of conviction are found to warrant setting aside records of that conviction and arrest. 4. That the defendant has fully complied with and performed all provisions of the sentence herein. American LegalNet, Inc. www.FormsWorkFlow.com IT IS HEREBY ADJUDGES AND DECREED that the defendant's conviction and arrest herein should be and the same hereby is set aside, pursuant to ORS 137.225, and hereafter the defendant, for all purposes of the law, shall be deemed not to have been previously convicted or arrested. IT IS FURTHER ORDERED that the Clerk of the Court shall forward a certified copy of this Order to all law enforcement agencies mentioned in the Court's file, including the following: a) b) c) d) The Federal Bureau of Investigation, The Oregon State Police, The Oregon State Corrections Division, The arresting Agency. IT IS FURTHER ORDERED that thereafter the record of conviction and arrest herein shall be sealed together with all other official records in this case, including investigation reports of the involved law enforcement agencies concerning the criminal case. Dated: _____________ Circuit Court Judge 17th Judicial District/Lincoln County, OR American LegalNet, Inc. www.FormsWorkFlow.com