COURT OF
WASHINGTON
FOR
Plaintiff
vs.
Defendant. No.
Motion and Declaration
for Order Vacating Conviction
(MTAF)
I. Motion
DEFENDANT asks the court for an order vacating his or her conviction of misdemeanor or gross
misdemeanor offenses. This motion is based on RCW 9.96.060, the case record and files, and the
declaration of defendant.
Dated:
Defendant/ Defendant's Attorney/ WSBA #
Print Name
II. Declaration of Defendant
I, , state as follows:
2.1. On _________________________________________(date) I was convicted of the following
offense(s):
Count No: ____ Offense: _____________________________ ( Check any applicable boxes
below )
Excluded Offense Prior Offense Domestic Violence Prostitution with Trafficking
Count No: ____ Offense: _____________________________ ( Check any applicable boxes
below )
Excluded Offense Prior Offense Domestic Violence Prostitution with Trafficking
MT/DECL FOR ORD VACATING CONV (MTAF) - Page 1 of 4
CrRLJ 09.0100 - (07/2017) RCW 9.96.060
Count No: ____ Offense: _____________________________ ( Check any applicable boxes
below )
Excluded Offense Prior Offense Domestic Violence Prostitution with Trafficking
2.2 There are no criminal charges pending against me in any court of this state or another state, or in
any federal court (RCW 9.96.060(2)(a));
2.3 Excluded Offenses : The offense for which I was convicted is a misdemeanor offense and not
one of the following offenses (RCW 9.96.060(2)(b)-(d)):
A violation of chapter 9A.44 RCW (sex offenses)
A violation of chapter 9.68 RCW (obscenity and pornography)
A violation of chapter 9.68A RCW (sexual exploitation of children)
A violent offense as defined in RCW 9.94A.030 or an attempt to commit a violent offense
Driving while under the influence (“DUI”), RCW 46.61.502
Actual physical control while under the influence, RCW 46.61.504
Operating a railroad, etc. while intoxicated, RCW 9.91.020
2.4 Prior Offense : The offense for which I was convicted is considered a “prior offense” under
RCW 46.61.5055 (see below), and
the prior offense is not otherwise excluded from being vacated (see excluded
offenses above); and
I have not been convicted of any new crime in this state, another state, or federal
court since I was convicted in this matter. RCW 9.96.060(2)(g); and
at least three years have passed since I completed the terms and conditions of the
sentence, including restitution/legal financial obligations. RCW 9.96.060(2)(f); and
I have not had another alcohol or drug violation within ten years of the date of arrest
for the prior offense; and
more than ten years have passed since the date of the arrest for the prior offense.
A “prior offense” means( RCW 46.61.5055(14)):
Original Convictions for the following (including equivalent local ordinances):
o Driving Under the Influence (DUI) RCW 46.61.502
o Physical Control of a Vehicle Under the Influence (Physical Control) RCW 46.61.504
o Commercial Vehicle DUI/Physical Control, RCW 46.25.110
o Watercraft DUI, RCW 79A.60.040(2)
o Aircraft DUI, RCW 47.68.220, committed under the influence of intoxicating liquor or any
drug;
o Nonhighway vehicle DUI, RCW 46.09.470(2)
o Snowmobile DUI, RCW 46.10.490(2);
o Equivalent out-of-state statute for any of the above offenses.
Amended Convictions for the following : If originally charged with DUI or Physical Control or
an equivalent local ordinance, or Vehicular Homicide (RCW 46.61.520) or Vehicular Assault
(RCW 46.61.522) ; but convicted of:
o Negligent Driving 1st RCW 46.61.5249
o Reckless Driving RCW 46.61.500
o Reckless Endangerment RCW 9A.36.050
o Equivalent out-of-state or local ordinance for the above offenses.
If originally charged with Watercraft DUI (RCW 79A.60.040(2); but convicted of
o Operating a Watercraft in a reckless manner, RCW 79A.60.040(1), or
o an equivalent local ordinance.
MT/DECL FOR ORD VACATING CONV (MTAF) - Page 2 of 4
CrRLJ 09.0100 - (07/2017) RCW 9.96.060
If originally charged with Aircraft DUI (RCW 47.68.220); but convicted of
o Operating an Aircraft in a careless or reckless manner, RCW 47.68.220, or
o an equivalent local ordinance.
Deferred Sentences for the following : If originally charged with DUI or Physical Control or
an equivalent local ordinance, or Vehicular Homicide (RCW 46.61.520) or Vehicular Assault
(RCW 46.61.522); but deferred sentence was imposed for:
o Negligent Driving 1st RCW 46.61.5249
o Reckless Driving RCW 46.61.500
o Reckless Endangerment RCW 9A.36.050
o Equivalent out-of-state or local ordinance for the above offenses.
2.5 Domestic Violence : The offense for which I was convicted involves domestic violence and I
have complied with the following conditions (RCW 9.96.060(2)(e)):
I provided the prosecuting attorney's office that prosecuted the offense with written notice
of this petition. RCW 9.96.060(2)(e)(i).
I filed the original notice with this court. RCW 9.96.060(2)(e)(i).
I have not been convicted of any other domestic violence offense arising out of any other
incident prior to the offense which I am seeking to vacate. RCW 9.96.060(2)(e)(ii).
It has been at least five years since I completed the terms and conditions of the sentence,
including restitution/legal financial obligations and successful completion of any treatment
ordered. RCW 9.96.060(2)(e)(iv).
I have not been convicted of any new crime in this state, another state, or federal court
since I was convicted in this matter. RCW 9.96.060(2)(g).
2.6 Prostitution Conviction as a Victim : The conviction was for a prostitution offense and I
committed the offense as a result of being a victim of trafficking, promoting prostitution in the
first degree, or promoting commercial sexual abuse of a minor. (If this box is checked, you
must fill out and submit the Prostitution Conviction Attachment form to support your motion.)
2.7 Offenses not otherwise specified above :
The offense for which I was convicted is not an Excluded Offense, a Prior Offense, a
Conviction for Prostitution as a Victim of Trafficking, and did not involve Domestic
Violence.
At least three years have passed since I completed the terms and conditions of the
sentence, including restitution/legal financial obligations. RCW 9.96.060(2)(f).
I have not been convicted of any new crime in this state, another state, or federal court
since I was convicted in this matter. RCW 9.96.060(2)(g).
2.8 I have never had the record of another conviction vacated. RCW 9.96.060(2)(h).
2.9 I am not currently and have not been restrained within the last five years by a domestic violence
protection order, a no-contact order, an anti-harassment protection order, or a civil restraining
order which restrains one party from contacting the other party. RCW 9.96.060(2)(i).
I declare under penalty of perjury under the laws of the state of Washington that the foregoing is, to the
best of my knowledge, true and correct.
Signed on ___________________________, at ________________________________________,
Washington.
_______________________________________
MT/DECL FOR ORD VACATING CONV (MTAF) - Page 3 of 4
CrRLJ 09.0100 - (07/2017) RCW 9.96.060
Defendant
____________________________________________________________________________________
Address
MT/DECL FOR ORD VACATING CONV (MTAF) - Page 4 of 4
CrRLJ 09.0100 - (07/2017) RCW 9.96.060
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