Fill and Sign the Section 610140 Expungement of Certain Criminal Records Form

PETITION TO EXPUNGE CRIMINAL RECORDS Missouri Revised Statutes Chapter 610 Control Number MO-EXPCRI-01 FORMS INCLUDED Form One - Petition to Expunge Form Two - Order to Expunge IN THE CIRCUIT COURT OF __________________________ COUNTY, MISSOURI AT __________________________ __________________________ PLAINTIFF, CASE NO. _______________________ v.DEFENDANT(S): CIRCUIT COURT DIVISION COUNTY SHERIFF'S DEPT. ASSOCIATE COURT DIVISION MUNICIPAL POLICE DEPT MUNICIPAL COURT DIVISION MISSOURI HIGHWAY PATROL TROOP CRIMINAL RECORDS REPOSITORY PROSECUTOR'S OFFICE (INCLUDE NAME OF COUNTY OR CITY) COUNTY MUNICIPAL OTHER (INCLUDE NAME AND ADDRESS OF AGENCY) _____________________ DEFENDANTS. Petition to Expunge Records of Arrest Pursuant to Section 610.122, RSMo, I request that the court issue an order to expunge my record of arrest, for the following criminal case: _____________________________I am filing this petition in the county where the arrest occurred and I hereby swear that I have no prior or subsequent misdemeanor or felony convictions and I did not receive a suspended imposition of sentence (SIS) for the offense for which the arrest was made or for any offense related to the arrest. I also state that the arrest was based on false information, there is no probable cause at the time of the action to expunge to believe that I committed the offense and charges will be pursued as a result of the arrest, and no civil action is pending relating to the arrest or the records sought to be expunged .I am providing my fingerprints on a standard fingerprint card for verification of my identity.I have reason to believe the agencies named above as defendants may possess records subject to expungement.I swear the facts stated in this petition are true according to my best knowledge and belief.: A. Information 1.The Petitioner's:(A)Full Name is __________________________(B) Sex Male Female (C)Race __________________________(D) Date of Birth __________________________ (day) (month) (year) (E)Driver's License Number __________________________(F)Social Security Number __________________________(G)Address at the time of the arrest __________________________2. The offense charged against the petitioner __________________________3.The date the offense charged against the petitioner was alleged to have been committed__________________________ (day) (month) (year)4.The date the petitioner was arrested __________________________ (day) (month) (year) 5.The name of the county where the petitioner was arrested and if the arrest occurred in a municipality, the name of the municipality: __________________________ County__________________________ Municipality (if applicable);6.The name of the agency that arrested the petitioner __________________________7.The case number and court of offense Case No: __________________________Court: __________________________ 8. Citation Number __________________________9.If criminal charges were filed, date of dismissal or reversal ________________________10. Address at Time of Arrest Offense Charged __________________________11.A list of all law enforcement agencies, jails or other detention facilities, magistrates, courts, prosecuting attorneys, correctional facilities, central state depositories of criminal records, and other officials or agencies or other entities of this state or of any political subdivision of this state and of all central federal depositories of criminal records that the petitioner has reason to believe have records or files that are subject to expunction. __________________________ ______________________________________________________________________________ __________________________ __________________________ ______________________________________________________________________________ B.Basis for Expunction 1.There is no probable cause, at the time of the action to expunge, to believe the individual committed the offense;2.No charges will be pursued as a result of the arrest;3.The subject of the arrest has no prior or subsequent misdemeanor or felony convictions;4. The subject of the arrest did not receive a suspended imposition of sentence for the offense for which the arrest was made or for any offense related to the arrest; and 5.No civil action is pending relating to the arrest or the records sought to be expunged. Respectfully submitted,**By_____________________________ ** IN THE CIRCUIT COURT OF __________________________ COUNTY, MISSOURI AT __________________________ __________________________ PLAINTIFF, CASE NO. _______________________ v.__________________________ DEFENDANTS. ORDER OF EXPUNGEMENT The Court having reviewed Petitioner's Petition for Expunction of Records and having found as follows:1. That Petitioner was arrested on the ________ day of __________________________, ____________ by __________________________ (law enforcement agency) for the following charge: __________________________ filed under the following case number(s): __________________________2. The Petitioner has met all of the conditions for expunction and the Court is satisfied that there are no reasonable objections to Petitioner's petition;IT IS HEREBY ORDERED:1.All records in Petitioner's case in the custody of this court, any other court, or any state, county or local entity, agency or official, as identified in the above petition, shall be sealed pursuant to Missouri Revised Statutes, Chapter 610, Sections 610.122 – 610.126, inclusive.2. A copy of this Order shall provided to the following agencies:________________________________________________________________________________________________________3.Any state agency that sent information concerning the arrest to a central federal depository shall request such depository to return all records and files subject to this Order of Expunction. DATED this ________ day of __________________________, 20 ________.____________________________________JUDGE