IN THE CIRCUIT COURT OF THE STATE OF OREGON FOR THE THIRD JUDICIAL DISTRICT ________________________________________,) Plaintiff, ) AFFIDAVIT IN SUPPORT OF MOTION v. ) TO SET ASIDE RECORDS OF ARREST ) STATE OF OREGON, ) Case No. _________________________ Defendant. ) STATE OF OREGON ) ) ss COUNTY OF MARION ) I, ____________________________________, do hereby depose and say that: I am the Plaintiff herein, and I am filing this Affidavit in Support of my Motion to Set Aside and toseal the records of my arrest. This arrest occurred more than one (1) year ago. I have no criminal cases presently pending againstme in any court. I have no criminal convictions in the ten (10) year period immediately preceding thefiling of this motion, excluding motor vehicles violations. I have not had a conviction set aside withinthe ten (10) year period immediately preceding the filing of this Motion and have no other similarmotions pending in this or any other court. I have not been arrested for any other matter unassociated with this within the last three (3) years,excluding motor vehicles violations. A copy of this Affidavit and a copy of my Motion to Set Aside Records of Arrest has been servedupon the District Attorney of Marion County. A complete set of my fingerprints has been served on the District Attorney of Marion County. I am not now charged with the alleged commission of any crime. The arrest that I am seeking to have set aside occurred on ______________________________. The charge(s) that I was arrested for on the above date was (were): ______________________________________________________________________________________________________________ Arresting agency and incident number _____________________________. Dated: _____________________._________________________________________ Signature of Plaintiff SUBSCRIBED AND SWORN TO before me this ________ day of ____________, _________. _________________________________________ Deputy Clerk of Court/Notary Public of Oregon My Commission Expires: ____________________AFFIDAVIT IN SUPPORT OF MOTION TO SET ASIDE RECORDS OF ARREST - Page 1 of 1 FC(11/10/03)