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File No. Name And Address Of Petitioner PETITION AND MOTION IN THE CAUSE FOR EXPUNCTION OF JUVENILE RECORD (UNDISCIPLINED/DELINQUENT) STATE OF NORTH CAROLINA County In The General Court Of Justice District Court Division IN THE MATTER OF Date Of Birth Age G.S. 7B-3200 I petition the Court to order the expunction of all records dated (date of adjudication) in which I was adjudicated undisciplined delinquent for the offense of (specify offense) . In support thereof I respectfully show that I have: (Applicable to all petitioners) 1. Attained the age of 18 years. 2. Been of good behavior since the adjudication. 3. Attached to this petition two veri�ed af�davits of good character, pursuant to G.S. 7B-3200(c)(2) (see Af�davit Of Good Character, AOC-J-904). 4. The offense for which I was adjudicated delinquent would not have been a Class A-E felony if committed by an adult. (Applicable only when the adjudication was for delinquency.) 5. At least eighteen (18) months have elapsed since I was released from juvenile court jurisdiction and I have not been adjudicated delinquent again or convicted as an adult of any felony or misdemeanor other than a traf�c violation under the laws of the United States or the laws of this State or any other state. I request that: 1. This petition be treated as an af�davit. 2. An order be issued to expunge the records of the adjudication as provided by G.S. 7B-3200. Date Signature Of Petitioner Date Title Signature Of Person Authorized To Administer Oaths Date My Commission Expires SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME SEAL Notary HEARING ON PETITION Deputy CSC Assistant CSC Clerk Of Superior Court Date Of Hearing Place Of Hearing Date Petition Filed Signature Date Time Of Hearing AM PM CERTIFICATE OF SERVICE I certify that a copy of this motion was served by: delivering a copy personally to the prosecutor. depositing a copy enclosed in a postpaid properly addressed envelope in a post office or official depository under the exclusive care and custody of the U.S. Postal Service directed to the prosecutor. leaving a copy at the office of the prosecutor with an associate or employee. Service accepted by the prosecutor. Name Of Person With Whom Copy Left (type or print) Signature Of Person Accepting Service Date Service Accepted Signature Of Person Serving Date Served NC-JOIN No. AOC-J-903, Rev. 12/17, © 2017 Administrative Of�ce of the Courts