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Petition For RCW 9.41.040-9.41.047 Certificate Form. This is a Washington form and can be use in Spokane Local County.
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Tags: Petition For RCW 9.41.040-9.41.047 Certificate, Washington Local County, Spokane
(Copy Receipt)
(Clerk’s Date Stamp)
SUPERIOR COURT OF WASHINGTON
COUNTY OF SPOKANE
Petitioner:
CASE NO.
vs.
PETITION FOR RCW 9.41.040/9.41.047
CERTIFICATE
Respondent: STATE OF WASHINGTON
COMES NOW,
Certificate.
, petitioner, and petitions the Court for an RCW 9.41.040/9.41.047
1. I have been convicted of the following crimes(s):
Type of Crime
Date of Sentencing
Court/Location
2. Attached is a certified copy of the Order(s) of the Court where I was sentenced that I
have successfully completed the terms and conditions of each sentence.
3. I have no criminal charges pending in any court of this state or any other state, or in any
federal court.
4. Attached is a certified copy of the record of all my criminal convictions.
5. None of my criminal convictions are a “violent offense” as described in RCW 9.94A.030.
A “violent offense” is described as:
PETITION FOR RCW 9.41.040/9.41.047 CERTIFICATE
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a)
b)
c)
d)
e)
f)
g)
h)
i)
j)
k)
l)
m)
Any Class A Felony
Any attempt to commit a Class A felony;
Criminal solicitation of or criminal conspiracy to commit a Class A felony;
Manslaughter in the first degree;
Manslaughter in the second degree;
Indecent liberties by forcible compulsion;
Kidnapping in the second degree;
Arson in the second degree;
Assault in the second degree;
Assault of a child in the second degree;
Extortion in the first degree;
Robbery in the second degree;
Vehicular assault or vehicular homicide when the driver is under the influence of
alcohol or drugs or operates the vehicle in a reckless manner.
6. The offense involved was a “crime against children or other persons” as described by
RCW 3.43.830(5), and more than one year has passed since successful completion of any
sentence, as required by RCW 9.41.070(g)(ii). A “crime against children or other
persons” is described as any of the following offenses.
a)
b)
c)
d)
e)
f)
g)
h)
i)
j)
k)
l)
m)
n)
o)
p)
q)
r)
s)
t)
u)
v)
w)
x)
y)
Aggravated murder;
First or second degree murder;
First or second degree kidnapping;
First, second, or third degree assault;
First, second, or third degree assault of a child;
First, second, or third degree rape;
First, second, or third degree rape of a child;
First or second degree robbery;
First degree arson;
First degree burglary;
First or second degree manslaughter;
First or second degree extortion;
Indecent liberties;
Incest;
Vehicular homicide;
First degree promoting prostitution;
Communications with a minor;
Unlawful imprisonment;
Simple assault;
Sexual exploitation of minors;
First or second degree criminal mistreatment;
Child abuse or neglect as defined in RCW 26.44.020;
First or second degree custodial interference;
Malicious harassment;
First, second, or third degree child molestation;
PETITION FOR RCW 9.41.040/9.41.047 CERTIFICATE
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z)
aa)
bb)
cc)
dd)
ee)
ff)
gg)
hh)
ii)
jj)
First or second degree sexual misconduct with a minor;
First or second degree rape of a child
Patronizing a juvenile prostitute;
Child abandonment;
Promoting pornography;
Selling or distributing erotic material to a minor;
Custodial assault
Violation of child abuse restraining order;
Child buying or selling;
Prostitution;
Felony indecent exposure.
7. The offense involved was
not a Class B felony or
since the offense was committed.
more than ten years have passed
8. The offense involved was
not a Class C felony or
since the offense was committed.
more than ten years have passed
9. I have never been convicted of a felony crime where a firearm was used.
10. I have never been convicted of three or more violations of Washington’s firearms’ laws
within any five-year period.
11. I have not had a firearm forfeited in the last five years for a drug or alcohol incident
pursuant to RCW 9.41.098(1).
12. I am not under a court order, either civil or criminal, prohibiting the possession of a
firearm.
13. I have not been convicted of driving under the influence of drugs or alcohol three times in
the last five years.
14. I have never been involuntarily committed for mental health treatment under RCW
71.05.320, 71.34.090, Chapter 10.77 RCW, or equivalent statutes of another jurisdiction.
I CERTIFTY AND DECLARE UNDER PENALTY OF PERJURY UNDER THE
LAWS OF THE STATE OF WASHINGTON THAT THE ABOVE IS TRUE AND CORRECT.
DATE:
Petitioner
PLACE OF SIGNING:
(City/State)
PETITION FOR RCW 9.41.040/9.41.047 CERTIFICATE
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