Fill and Sign the Petition and Order for Termination of Sex Offender Registration Form

NOTE TO PETITIONER: If the conviction requiring your registration occurred in North Carolina, file this petition with the Clerk of Superior Court in a county that is located in the Superior Court District in which you were convicted. If the conviction requiring your registration occurred in another state or in any federal court, file this petition with the Clerk of Superior Court in a county that is located in the Superior Court District in which you currently reside. The petitioner named above hereby moves for termination of sex offender registration under Part 2 of Article 27A of Chapter 14 of the General Statutes and, in support of this petition, states the following:\ 1. I was required to register as a sex offender under Part 2 of Article 27A of Chapter 14 of the General Statutes for the offense(s) set out above. 2. I have been subject to the North Carolina registration requirements of P\ art 2 of Article 27A for at least ten (10) years beginning with the Date Of Initial NC Registration above. 3. Since the Date Of Conviction above, I have not been convicted of any sub\ sequent offense requiring registration under Article 27A of Chapter 14. 4. Since the completion of my sentence for the offense(s) set out above, I have not been arrested for any offense that would require registration under Article 27A of Chapter 14. 5. If applicable, I filed a previous petition for termination under G.S. 14-208.12A, which was denied on (date) in (name of county) and one year or more has passed since the date of the denial. 6. If the conviction requiring my registration occurred in another state or\ in any federal court, (i) I have provided written notice to the sheriff of the county where I was convicted that I am petitioning the court to t\ erminate the registration requirement and (ii) I am including with this petition an affidavit, signed by me, that verifies that I have notified the sheriff of the county where I was convicted of this petition and that provides the mailing address and contact information for that sheri\ ff. I. PETITION NOTE: No hearing may be held on this matter until at least three (3) weeks after notice to the District Attorney. The undersigned accepts service of this petition on behalf of the Office of the District Attorney. Date Signature Of Petitioner II. SERVICE ON DISTRICT ATTORNEY Date Name (type or print) Title (type or print) Signature Name And Current Mailing Address Of Petitioner PETITION AND ORDER FOR TERMINATION OF SEX OFFENDER REGISTRATION STATE OF NORTH CAROLINA County (Over) IN THE MATTER OF Name And Address Of Petitioner’s Attorney Attorney’s Telephone No. Sex Offender And Public Protection Registry No. Petitioner’s Telephone No. File No. In County Of Hearing In The General Court Of Justice Superior Court Division G.S. 14-208.12A County And State Of Conviction Date OfConviction Offense Description File No.(s) OfCounty Of Origin Date Of InitialNC Registration Race Sex Date Of Birth AOC-CR-262, Rev. 7/17