Fill and Sign the Docket Number 490213297 Form

CRIMINAL ) COMMONWEALTH OF PENNSYLVANIA ) Docket Numbe r ) ) Defendant ) ORDER AND NOW, this day of , 20 , upon consideration of the within Motion of__________________________________________, it is ORDERED AND DECREED, that the criminal history record inform ation relating to the arrest(s) detailed herein, be expunged in accordance with the provisions of the Criminal History Record Information (C.H.R.I.) Act, 18 Pa.C.S. §§ 9101 et seq., as directed on the reverse hereof: Defendant’s Name: Date of Birth : SSN: OTN: MDJ Docket No.: Magisterial District No.: Common Pleas Docket No. Charges: Date of Arrest: Arresting Police Agency: Disposition: Reason for Expungement: For Court use only. Clerk to serve Order on: Arresting Police Agency PSP Central Repository Issuing Authority Defendant or counsel District Attorney BY THE COURT: Defendant’s Current Address Defendant’s Day Time Phone No.: J. IN THE COURT OF COMMON PLEAS OF ______________ COUNTY, PENNSYLVANIA vs. ) IT IS SPECIFICALLY ORDERED THAT: a. Serve one copy of the within Order on the defendant or the defendant’s counsel. b. Serve certified copies of the within Motion and Or der upon the arresting police agency, the Pennsylvania State Police Central Repository, and, if this Order involves expungement of a case or cases finalized in the District Justice Courts (where there was a dismissal, di scharge or other final disposition at the District Justice level, and no bind-over or appeal to, or other disposition in a court of record), one copy of the Motion and Order for service upon the proper issuing authority or authorities. c. Serve one copy of the said Motion and Order on the Attorney for the Commonwealth, and, d Note the expungement on the records of the within case(s), if the case(s) were finally disposed of in the Court of Common Pleas. 2. The arresting police agency, upon recei pt of a certified copy of the within Motion and Order from the Clerk of Judicial Records shall: a. Note the expungement on the records of the within case(s) maintained by their department, and expunge from any local RAP sheets or their equivalent maintain ed by said police agency a ny reference to the within case(s); and b. Within thirty (30) days of receipt of this Motion and Order, file with the Clerk of Judicial Records--Criminal for Lehigh County, a verification that paragraph 2 of this Order has been complied with. 3. The Pennsylvania State Police Central Repositor y, upon receipt of a certified copy of the within Motion and Order from the Clerk of Judicial Records shall: a. Expunge their records in accordance with this Order; and b. As required by the Criminal History Record Informa tion Act, 18 Pa.C.S. § 9122 (d), "notify all criminal justice agencies which have received the criminal hi story record information to be expunged" of this expungement order; and c. Within thirty (30) days of receipt of this Motion and Order, file with the Clerk of Judicial Records--Criminal for Lehigh County, a verification that paragraph 3 of this Order has been complied with. 4. The Attorney for the Commonwealth and any i ssuing authority, upon receipt of this Motion and Order shall note the expungement on the records of their offices, if any, relating to the case(s). IN ACCORDANCE WITH THE C.H.R.I. ACT, NOTHING IN THIS ORDER SHA LL BE CONSTRUED TO REQUIRE: A. The expungement of public records which are exem pt from expungement by 18 Pa .C.S. § 9104 (e), namely, "[o]riginal records of entry compiled chronologically, including but not limited to, police blotters and press releases that contain criminal history record info rmation and are disseminated contemporaneous with the incident", "[a]ny documents, records or indices prepar ed or maintained by or filed in any court of the Commonwealth, including but not limited to the minor j udiciary", "[p]osters, announcements, or lists for identifying or apprehending fugitives or wanted pers ons", or "[a]nnouncements of executive clemency." 18 Pa.C.S. § 9104 (a). B. The expungement of non-criminal history record information which is exempt from expungement by 18 Pa.C.S. § 9102, namely, intelligence information (defined in 18 Pa.C.S. § 9102 as "[i] nformation concerning the habits, practices, characteristics, possessions, associations or financial status of any individual"), investigative information (defined in 18 Pa.C.S. § 9102 as "[i]nformati on assembled as a result of the performance of any inquiry, formal or informal, into a criminal incident or an allegation of crim inal wrongdoing and may include modus operandi information), including medical and psyc hological information, or information specified in 18 Pa.C.S. § 9104". (Other than as specified in 1, above, this includes: "[c]ourt dockets , police blotters [including any reasonable substitute therefore] and information contained therein"). C. The expungement of information require d or authorized to be kept by the prosecuting attorney, the central repository and the court by 18 Pa.C.S. § 9122 (c), relati ng to diversion or pre-c onviction probation programs such as Accelerated Rehabilitative Disposition. 1. The Clerk of Judicial Records--Criminal for ____________ County shall: