Expungement Of Criminal Record Form

CPN Cost Rec. # Exp. Rec.# Date Pd. Date Pd. ORDER FOR THE EXPUNGEMENT OF CRIMINAL OFFENDER RECORD State of Tennessee vs. Criminal Docket No. General Sessions Docket No. In the General Sessions/Criminal Court of Davidson County, Tennessee at Nashville on Motion or Petition of above named defendant Defendant/Arrest Information: NAME used at time of arrest RACE SEX DATE OF BIRTH Arresting Agency OCA CHARGE 1 (as shown on fingerprint card) DATE OF ARREST CHARGE 2 (as shown on fingerprint card) SOCIAL SECURITY NUMBER CHARGE 3 (as shown on fingerprint card) Disposition Information Final Charge 1 Final Charge 2 Final Charge 3 FINAL DISPOSITON DIVERSION DATE (if applicable) The defendant named above is entitled to have all PUBLIC RECORDS relating to the offense listed above expunged according to the Tennessee Code Annotated provision marked below: Provisions Relating to Juveniles: Provisions Relating to Adult Charge has been dismissed (TCA 40-32-101) Petition alleging delinquency not filed (TCA 37-1-155) Proceedings dimissed after petition is filed or the case is transferred to the Juvenile Court as provided in TCA 37-1-109 (TCA 37-1-155) Adjudicated not to be a delinquent child (TCA 37-1-155) Child has reached eighteen (18) years of age and there is no record that he committed a criminal offense after reaching sixteen (16) years of age, unless such fingerprints were obtained on alleged charge which if committed by an adult would be a felony (TCA 37-1-155) Passage of six (6) months from date of liquor law violations defined by TCA 57-3-412(a)(3)(c) or TCA 57-3-301 (e) (3) No true bill returned by Grand Jury (TCA 40-32-101) Verdict of not guilty returned by jury (TCA 40-32-101) Conviction which has by appeal been reversed (TCA 40-32-101) Nolle prosequi entered into case (TCA 40-32-101) Successful completion of all probation provisions and proceedings against Defendant have been discharged by the court (TCA 40-35-313) Suspension of prosecution pursuant to (TCA 40-15-105) It is ordered that all PUBLIC RECORDS relating to such offense above referenced be expunged and immediately destroyed upon payment of all cost to clerk and that no evidence of such records pertaining to such offense be retained by any municipal, county or state agency, except non-public confidential information retained in accordance with TCA 10-7-504 and TCA 38-6-118. APPROVED FOR ENTRY Entered Defendant Bar ID AOC- day of / Attorney for Defendant Judge Court of Davidson County Div. RDA Pending Assistant District Attorney Date American LegalNet, Inc. www.FormsWorkFlow.com