Fill and Sign the How to File a Petition to Expunge Summary Form

Disclaimer 05/20/2010 HOW TO FILE AN ARD EXPUNGEMENT The Court assumes no responsibility and accepts no liability for actions taken by users of these documents, including reliance on their contents. If you want to obtain the services o f an attorney but do not know whom to contact, you may call the Lawyer Referral service. The information in th is packet is not to be a substitute for professional legal advice. EXPUNGEMENT INSTRUCTIONS Accelerated Rehabilitative Disposition ( ARD ) Expungement If you have completed the Accelerated Rehabilitative Disposition (ARD) program, you are eligible to file a Petition for Expungement.* Please complete the follow ing steps: 1.) Prepare your Petition for Expungement. You will need to complete the attached form with the following information in order to complete your Petition for Expungement: (1) Your full name, Date of Birth and Social Security Number; (2) OTN (Offense tracking number) (3) Magisterial District Judge Docket Number and M agisterial District Number or M unicipal Court Docket Number; (4) Court of Common Pleas Docket Number, if any; (5) The specific charges to be expunged as they appear on Criminal Complaint; (6) The Date of Arrest and the Criminal Justice Agency which made the arrest; (7) The Reason for Expungement; (8) The Date of Acceptance into ARD and the Sentencing Judge; and (9) The Criminal Justice Agencies upon which certified copies of the Order shall be served. 2.) Complete the Affidavit Form (Exhibit “A”). This document needs to be notarized prior to filing the Expungement. 3.) Complete the Certification of Agency Form (Exhibit “B”). This document needs to be signed and completed prior to filing the Expungement by the Adult Probation and Parole 4) Complete a Certificate of Service Form (Exhibit “C”). You must serve a copy of this Order and Petition simultaneously with filing. Service of this Order and Petition must be by personal delivery or by mailing one copy of each by U.S. first class mail, postage pre- paid, in accord with Pa.R.Crim.P. 576(B). If you choose the personal delivery option , line on the Certificate of Service indicating the date you actually either personally delivered or mailed your Order and Petition. You must also attach a completed copy ofyour Certificate of Service to your Petition before you file and serve it. Off .i ce .This needs to be filled out by the Probation Officer that supervised your probation period. you must deliver a copy of the Order and Petition to the District Attorney of your Attorney's Office. County or you may choose to mail a copy of the Order and Petition to the District Regardless of which service option you choose, you must type or write the address on the blanks provided on the Certificate of Service. You must fill in the date *If you are pursuing an expungement not related to completion of the ARD program, it is recommended that you consult an attorney. 5) File the Original and fourteen (14) copies with the Clerk of Courts. Also, a $36.75 (only money order or cash will be accepted) NON-REFUNDABLE filing fee is required at the time of submission. CRIMINAL DIVISION COM M ONW EALTH OF PENNSYLVANIA : : v. : DOCKET NO.: ____________ : _______________________________ (name) : OTN: ____________ : MOTION FOR ORDER DISMISSING CRIMINAL CHARGES AND TO EXPUNGE CRIMINAL RECORD The M otion of___________________________________(name), the above-named Defendant, respectfully represents as follows: 1. The defendant was charged at the above number and term with _________________ (charge (s) including section and subsection). 2. On or about ______________________(date of acceptance into ARD), after accepting the conditions of probation and agreeing to comply with the terms therewith, was placed in the Accelerated Rehabilitative Disposition Program, for a period of __________ (period of time in ARD) by the Honorable______________________(name of sentencing judge). 3. Defendant has completed the probationary period and has complied with all conditions of probation, including specifically, that Defendant has not been arrested or charged with any violation of the law. In support thereof, Defendant has attached an affidavit, which is marked Exhibit “A”. Also attached to this M otion, as Exhibit “B” is the Certification of the Adult Probation Department. 4. A true and correct copy of this Motion and supporting documents was served upon the District Attorney of Lancaster County. 5. Defendant is entitled by the successful completion of Accelerated Rehabilitative Disposition (ARD), and upon the dismissal of these proceedings, that an Order be entered that there is not, nor shall there be, a conviction for any purpose whatsoever, unless otherwise provided by law. IN THE COURT OF COM M ON PLEAS OF ________________ COUNTY, PENNSYLVANIA W HEREFORE, the Defendant requests the Court enter an Order expunging and destroying all arrest records, files and any other documents pertaining to the above listed arrest and prosecution of Defendant for the above listed charges. Respectfully submitted, Dated:________________ ____________________(signature of defendant) ____________________(name) ____________________(address) ____________________(address) ____________________(phone number) CRIMINAL DIVISION COM M ONW EALTH OF PENNSYLVANIA : : v. : DOCKET NO.: ____________ : _______________________________ (name) : OTN: ____________ : D.O.B.: ___________ (date of birth) : M .D.J. ____________ (Magisterial District Judge) S.S.N: ___________ (social security number) : M .D. No.: ____________ ORDER AND NO W , this_________day of______________, 20___, upon consideration of the foregoing Motion of Defendant, the Court discharges and dismisses the proceedings against Defendant without adjudication of guilt, and orders that this prosecution shall not constitute a conviction for any purpose whatsoever, unless provided otherwise by law. agencies listed below, the Magisterial District Judge, and all other keepers of the criminal records in this case who are to be served with a copy of the Order, except the Pennsylvania Department of Transportation pursuant to the Vehicle Code, 75 Pa. C.S.A. § 1534 (b), shall expunge and destroy all arrest records, files and any other documents pertaining to the arrest or prosecution for the charge(s) listed below; pursuant to the Defendant’s successful completion of Accelerated Rehabilitative Disposition (ARD); and to request, insofar as they are able, the return of such records that they have made available to federal and other state agencies, and to destroy such records upon receipt thereof. It is further ORDERED to file with this Court, within thirty days receipt of this Order, an affidavit that such records have been expunged and destroyed, together with the Court’s expunction order, and to retain no copies thereof. Information Pursuant to Pa.R.Crim.P, Rule 722: 6. Identifying information of Defendant: (a) Defendant’s Name:_______________________ (b) Defendant’s date of birth:__________________ IN THE COURT OF COM M ON PLEAS OF _____________________ COUNTY, PENNSYLVANIA It is further ORDERED and DECREED that the Clerk of Courts of _____________ County, the criminal justice (c) Defendant’s Social Security number:__________________ 2. OTN:__________________ 3. Docket numbers: (a) Magisterial District Judge number:______________________ (b) Magisterial District Judge docket number:____________________ (c) Court of Common Pleas docket number:_____________________ 4. Charge(s) to be expunged:__________________________________________________ 5. Date of arrest/citation:___________________ 6. Criminal Justice agency and Officer (name) making the arrest:__________________________________ 7. On or about________________________(date of acceptance into ARD), Defendant, after accepting the conditions of probation and agreeing to comply with the terms therewith, was placed in the Accelerated Rehabilitative Program for a period __________(period of time in ARD) by the Honorable________________________(name of sentencing judge). 8. Defendant has completed the probationary period and has complied with all conditions of probation, including specifically, that Defendant has not been arrested or charged with any violation of the law. 9. Criminal Justice agencies upon which certified copies of this Order shall be served: (a) ___________________________________________________ (b) ___________________________________________________ (c) ___________________________________________________ (d) ___________________________________________________ (e) ___________________________________________________ (f) ___________________________________________________ BY THE COURT: ___________________________ Judge Attest: EXHIBIT “A” CRIMINAL DIVISION COM M ONW EALTH OF PENNSYLVANIA : : v. : DOCKET NO.: ____________ : _______________________________ (name) : OTN: ____________ : AFFIDAVIT I, _______________________________ (name), being duly affirmed according to law, does hereby depose and say that the facts contained herein are true and correct; that your affiant is the above-named Defendant and makes this application requesting the Court to enter an Order dismissing the aforesaid charges against him. Defendant further swears and affirms that he has satisfactorily completed the program and complied with its conditions. __________________________ (signature) _____________________________ (name) Defendant Sworn to and subscribed before me this _____ day of _____________, 200__. ___________________________ Notary Public M y commission expires: IN THE COURT OF COM M ON PLEAS OF _____________________ COUNTY, PENNSYLVANIA EXHIBIT “B” CRIMINAL DIVISION COM M ONW EALTH OF PENNSYLVANIA : : v. : DOCKET NO.: ____________ : _______________________________ (name) : OTN: ____________ : CERTIFICATION OF AGENCY CHARGED WITH SUPERVISION OF DEFENDANT I, _______________________________ (name of probation officer), being a Probation Officer of the Lancaster County Adult Probation Office does, hereby certify that I supervised the probation of Defendant, terms and conditions of Defendant’s probation and that Defendant has complied with the terms and conditions of the probation and the signer herein does so certify. ______________________________________ (S) ___________________ (name of probation officer) Dated: _______________ IN THE COURT OF COM M ON PLEAS OF _______________________ COUNTY, PENNSYLVANIA _______________________, imposed by the Court of Common Pleas of ____________ County; that I am aware of the EXHIBIT “C” CRIMINAL DIVISION COM M ONW EALTH OF PENNSYLVANIA : : v. : DOCKET NO.: ____________ : _______________________________ (name) : OTN: ____________ : CERTIFICATE OF SERVICE I, hereby certify that on this day, one (1) copy of the foregoing, “Motion for Order Dismissing Criminal Charges and to Expunge Criminal Record”, was served upon the person at the address set forth below by, (list type of service), in compliance with Pa.R.Crim.P. 576(B)(2): _______________________________ _______________________________ _______________________________ Dated: _______________ ____________________________ Defendant’s Name Defendant’s Address Defendant’s Telephone Number IN THE COURT OF COM M ON PLEAS OF _________________ COUNTY, PENNSYLVANIA