Fill and Sign the Da V Oklahoma Ex Rel Oklahoma State Bureau of Investigation Form

AOC-496.2 Doc. Code: PEXC Rev. 7-16Page 1 of 2 Commonwealth of Kentucky Court of Justice www.courts.ky.gov KRS 431.078; 218A.275(8); 218A.276(8); 431.079 PETITION FOR EXPUNGEMENT (FOR MISDEMEANOR, VIOLATION, OR TRAFFIC INFRACTION CONVICTION) lexet justitia COMMONWEALTHOFKENTUCKY COURTOFJUSTICE COMMONWEALTH OF KENTUCKY PLAINTIFF VS. ________________________________________________ NAME DEFENDANT ________________________________________________ ADDRESS________________________________________________ _________________________________PHONE NUMBER Jail ID Number________________(optional) Defendant’s Birthdate:_______________Defendant’s SSN:__________________Violation/Arrest Date:_____________ Comes now the Defendant herein, and petitions the Court, pursuant to KRS 431.078, to expunge the following misdemeanor, violation, or traf�c infraction charge(s) in the above-referenced case: CHARGE: ____________________________________ CHARGE: __________________________________ CHARGE: ____________________________________ CHARGE: __________________________________ CHARGE: ____________________________________ CHARGE: __________________________________ In support of this Petition, the Defendant states as follows: 1. The Defendant was convicted of the misdemean or(s), violation(s) or traf�c infraction(s) charged above. 2. The above-stated offense(s) is/are not a sex offense(s) or an offense(s) committed against a child. 3. The Defendant has not, been convicted of a felony or misdemeanor in the �ve years prior to the �ling of this Petition. 4. The offense(s) is/are not subject to enhancement for a second or subsequent offense or the time for such enhancement has expired. 5. No proceeding concerning a felony or misdemeanor is pending or being instituted against Defendant. 6. This petition q is �led no sooner than �ve (5) years after completion of Defendant’s sentence or �ve (5) years after successful completion of the Defendant’s probation, whichever is later; OR q involves Defendant's 1st conviction for possession of controlled substances voided under KRS 218A.275(8); OR q involves a conviction for possession of marijuana or synthetic drugs or salvia voided under KRS 218A.276(8). 7. List the names and addresses of all victims of the crimes listed above and any other person(s) whom Defendant/Petitioner has reason to believe may have information relevant to the expungement: Victims: __________________________________________________________________________________ _________________________________________________________________________________________ Persons with relevant information: ___________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ NOTE: A SEPARATE PETITION MUST BE FILED FOR EACH CRIMINAL CASE AND THE CHARGE(S) MUST BE LISTED IN THIS PETITION FOR THE CHARGE(S) TO BE EXPUNGED. ADDITIONALLY, A COPY OF YOUR CURRENT EXPUNGEMENT ELIGIBILITY CERTIFICATION MUST BE ATTACHED TO THIS PETITION. Case No. ____________________ Court ____________________ County ____________________ Division ____________________ ( ) AOC-496.2 Rev. 7-16 Case No. __________________________ Page 2 of 2 The Defendant prays that this Petition for Expungement of a Misdemeanor, Violation, or Traf�c Infraction Conviction be granted and that this Court enter an Order that the following agencies expunge any records in the agencies custody regarding these charges: LIST AGENCIES AND ADRESSES HERE: _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ Note: Defendant/Petitioner must sign this petition in the presence of a notary or the circuit court clerk so that the notary/ clerk can notarize his/her signature. Date: ____________________________, _______. ___________________________________________ Defendant/Petitioner Signature This Petition for Expungement was sent on the ______ day of _______________________, ______, to Defendant/ Petitioner or his/her attorney; the County Attorney; all crime victim(s) identi�ed by Defendant/Petitioner or in the court record sought to be expunged; and all other person(s) whom Defendant/Petitioner has reason to believe may have information relevant to the expungement. ___________________ _________________________ Clerk By: _____________________________________ D.C. FOR CLERK USE ONLY NOTIFICATION OF EXPUNGEMENT HEARING This case is set for a hearing on _______________________, ______, at the hour of _______ q a.m. q p.m. at the ________________________________ q District q Circuit Court. Dated this _____ day of ___________________________, ______. ____ _____________________________________ Clerk By: _____________________________________ D.C. Subscribed and sworn to before me by ________________________________________________________________ this _______ day of ______________________, _______. ___ _________________________________________ Notary/Clerk My commission expires: ___________________, _______ By: ____________________________________ D.C. THERE IS A $100 FEE PER CASE, PAYABLE AT THE TIME OF FILING. THE CLERK CANNOT TAKE YOUR PETITION WITHOUT PROPER PAYMENT OF THE FEE. IF AN EXPUNGEMENT ORDER IS NOT GRANTED, $50.00 OF THIS FEE IS NOT REFUNDABLE. County LIST AGENCIES AND ADDRESSES HERE: