Fill and Sign the Record Release Form

IN THE ___________ COURT OF _______________ (County), ______________ (State) _________________________ PLAINTIFF (Name of State/Respondent) V. CAUSE NO. _______,________ ________________________ DEFENDANT (Name of Defendant/Petitioner) Petition for Expungement of Record in Case of Acquittal COMES NOW ______________________ (Name of Defendant/Petitioner) , Petitioner in the above-styled and numbered cause, by and through his attorney, and files this his Petition against Plaintiff/Respondent, __________________ (Name of State) , and in support thereof would show unto the Court the following matters and facts: 1. Petitioner was arrested by the ____________________________ (name of police department) on _______________ (date) , for (description of offense) __________________ ____________________________________________________________________________ ____________________________________________________________________________ . 2. Petitioner was released without being convicted on _____________________ (date) . 3. Petitioner has not previously, nor has he subsequently, been convicted of any criminal offense or any municipal ordinance violation, including violations of state vehicle code, and he has not since been arrested for any such offense and there are no criminal charges pending against him at the present time. 4. Petitioner has read this petition, knows what it says and states, under penalties of perjury, that it is true. WHEREFORE, Petitioner asks the court to expunge the Petitioner's arrest records. Respectfully submitted, ________________________ Name of Petitioner) By:______________________ (Printed Name of Attorney) _________________________ (Signature of Attorney) Petitioner’s Attorney State Bar No. ____________ Certificate of Service This is to certify that I, _____________________ (Name of Attorney) , attorney for Petitioner _____________________ (Name of Petitioner) , have this date served a true and correct copy of the above and foregoing Petition by U.S. Mail, postage fully prepaid, to the following counsel of record for the State: _______________________ (Name of Attorney) Post Office Box ________________ ___________________________________ City, State, Zip Code This the ____ day of ________________, 20_____. Respectfully Submitted, ________________________ (Printed Name of Attorney) ________________________ (Signature of Attorney) Petitioner’s Attorney State Bar No. ____________ OF COUNSEL: ________________________ (Name of Attorney) Post Office Box _______-__________ _______________________________ City, State, Zip Code Telephone: ______-______-_________