Fill and Sign the Form Aoc Cr 919 Download Fillable PDF Certificate of

(NOTE: This form is for issue by the clerk when a person whose rights were forfeited as a result of a conviction in another state or federal court presents a paper writing from the agency of the other state or of the United States that had jurisdiction over the person indicating that he/she has been discharged unconditionally and specifying the restoration of his/her rights of citizenship. For supervised probationers, parolees, and post-release supervisees discharged from supervision and inmates released from active sentences for North Carolina convictions, a certificate of restoration is issued by the supervising or custodial agency. For the restoration of rights for defendants in North Carolina cases not sentenced to supervised probation or imprisonment, see form AOC-CR-926.) Before The Clerk CERTIFICATE OF R ES TORATION OF CITIZENSHIP (OUT-OF-STATE OR FEDERAL CONVICTION) G.S.13-2(b) CERTIFICATE OF RESTORATION T he person na med above is a resident of the c ounty named above a nd was c onvicted of a crime against the United States or another state wh ereby his/her citizenship ri ghts were forfeited. Pursuant to G.S. 13-2(b), that person has presented to the undersigned a paper writ ing from the agency of the other state o r of the United States which h ad jurisdicti on over the person, stati ng that on the Date Of Dischar ge for the conviction shown below, the person named above was: 1. discharg ed unconditionally by t hat agency. 2. pardoned by the Pres ident of the United States or the Governor of the state in which the person was c onvicted, and that his/her pard on was: a. unconditional. b. conditional, and the person has satisfied t he conditi ons of the pardon. Pursuant to G.S. 13-1, the person’s citiz enship rights forfeited as a result of the case/conviction below have automatically be en restored. State Or U.S. District Court District Of Conviction County (if applicable)File/Case No. Date Of Discharge Date Of Certificate Name (Type Or Print) Signature NOTE TO CLERK:File the original of this certificate in your Regi stration files. Give a certified copy of this certificate to the named person. The filing fee for recording a document with the clerk must be collected. G.S. 7A-308(a)(11). CERTIFICATION I hereby certify that this form is a true and complete copy of the original on f ile in this off ic e. Date Name (Type Or Print) Signature NOTE TO RESTORED CITIZEN This certificate evidences the restoration of some, but not all, of the rights forfeited as the result of your conviction in the case listed above. Th is restoration app lies only to rights forfeited as a result of the specific case listed; it does not restore rights still forfeited as a result of other convictions. If you have no other convictions f or which your r ights were forfeited, this does restore yo ur rights to vote; to serve on a jury; and to r un for or hold most (but not all) el ected or appo inted offices in the State. To vote, you must first register with your local Board of Elections. Un less spe cifically restored by the laws or agency of the other state or of the United States, this certificate does not :  expunge, reverse, or conceal the record of conviction in the case listed above;  restore the righ t to possess a firearm;  restore a drivers license or other government-i ssued license that may have been revoked or suspend ed as a result of your conviction;  remove other c onsequences of convict ion, like registration as a sex offender or a court’s findi ng of domestic violence offender status;  satisfy outstanding civil obligations arising from t he criminal case, like attorney fees, restitution, or forfeitures;  prevent some licensi ng agencies or em ployers from considering your conviction in licensing or employment decisions; or  restore other ri ghts or privileges not specifically excluded here. Questions about the rights that are or are not restored by this certificate should be direct ed to an attorney or to the government agency with authority ov er the right or benefit in quest ion (e.g., the lo cal board of elect ions). The cl erk of s uperior court cannot give you legal advi ce about rights that are or are not restore d as a result of your discharge by t he other state or federal agency. AOC-CR-919, Rev . 5/13 © 2013 Administrative Office of the Courts File No. STATE OF NORTH CAROLINA County In The General Court O f Justice Superior Court Division Microfilm No. (Official Use Only) In The Matter Of The Restoration Of Citizenship Of: State Date Of Birth Social Security No. Sex Drivers License No. Race Name And Address Deputy CSC Assistant CSC CSC Deputy CSC Assistant CSC CSC R lnformation on registering to vote is available online at http ://www.ncsbe.gov .