MOTION FOR EXPUNGEMENT AND SEALING
NOW INTO COURT COMES _______________________________ , in proper person or through undersigned counsel, and herein moves this Honorable Court:
I.
Full name of mover:
_________________________________________________________________
SEX: { } Male { } Female Social Security Number: _________
Race/Ethnicity: ____________ Date of Birth: ____/____/ _____
Address: Street: ______________________________________ Apt. #: _______
City/State: __________________________________________ Zip: __________
NOTE: A separate page shall be completed for EACH of the charges for which expungement and sealing is sought. Failure to provide ALL of the requested information may result in dismissal of the motion for insufficiency.
II.
Offense Report #: ___________________ Offense charged: ________________
Date of Arrest: ____/____/ ________
Arresting Agency: ___________________________________________________
City/ Parish of Arrest: ________________________________________________
III.
Action taken: (Check appropriate action and insert date)
{ } Charges not filed
{ } Charges refused on ____/____/ ________
{ } Informal Adjustment Agreement completed on ____/____/ ________
{ } Adjudicated on ____/____/ ________
{ } Dismissed on ____/____/ ________
{ } Continued without date on ____/____/ ________
IV.
Court Docket and Complaint #: __________________ , # _____________
V.
Authority for motion (Check one only)
{ } This matter did not result in adjudication.
{ } This matter resulted in a Families in Need of Services or delinquency adjudication.
AND the court which had exercised juvenile jurisdiction has ceased to exercise such in accordance with Children’s Code Article 313.
AND the adjudication was not for murder, manslaughter, an offense requiring registration as a sex offender under R.S. 15:542, kidnapping, or armed robbery.
AND mover has no adult felony conviction and no adult conviction for a misdemeanor against a person involving a firearm.
AND mover has no pending indictment or bill of information against him.
WHEREFORE, mover prays that after due proceedings are had, there be an order herein in favor of mover, ordering the clerk of court and all other agencies, offices or organizations to expunge and seal their records or reports concerning the conduct or condition of mover as a child as more fully described herein.
Respectfully submitted,
_________________________________________
Name of Mover or Attorney
_________________________________________
Address
_________________________________________
City/State/Zip
_________________________________________
Phone
ORDER
CONSIDERING the above and foregoing:
IT IS ORDERED that a contradictory hearing be and is hereby set for the
______ day of _________________ , 20____ at _________ in Section ________.
_________________ , Louisiana this ______ day of __________________ 20___.
____________________________________
JUDGE
Note: Please add any additional necessary agencies below.
PLEASE SERVE:
Parish of ___________________
District Attorney ________________
Clerk of Court _________________
Sheriff ________________________
Bureau of Identification and Information
Attn: Expungement
7919 Independence Blvd.
Baton Rouge, Louisiana 70806
and
_____________________________ __________________________________
Name of Agency Name of Agency
_________________________________ ______________________________
Attn: Attn:
_________________________________ ______________________________
Address Address
_________________________________ ______________________________
City/State/Zip City/State/Zip
ORDER OF EXPUNGEMENT AND SEALING
CONSIDERING the Motion for Expungement and Sealing and the evidence adduced as to the following described matter, and as to the following described conduct or conditions:
|
Item #s |
Offense(s) Charged |
Date of Arrest(s) |
Arresting Agencies |
IT IS ORDERED that the clerk of court expunge and seal all records and reports, in any medium, including but not limited to pleadings, exhibits, reports, minute entries, correspondence, and all other documents. The court may maintain a confidential record of the fact of an adjudication, which may be released only upon written motion of a court exercising criminal jurisdiction over the mover herein and then only for purposes authorized by the Code of Criminal Procedure.
IT IS FURTHER ORDERED that all officials, agencies, institutions, boards, systems, and law enforcement officers and their employees, agents, and consultants expunge and seal all records and reports, in any form, concerning the above-described matter, and any other photographic, fingerprint, DNA, or any other information of any and all kinds and descriptions. The custodian of records and reports of the agency or office may maintain a copy of this order. However, the custodian shall not disclose to anyone the fact that an order is maintained or that the expunged and sealed records or reports previously existed except upon written order of the court.
IT IS FURTHER ORDERED that each agency and law enforcement office herein served and having any records or reports of the conduct or condition file a sworn affidavit with the clerk of court to the effect that the records and reports have been expunged and sealed and that no notation or references have been retained in any central depository which could or might lead to the inference that any report or record was on file with the agency or law enforcement office served, which affidavit shall be filed with the clerk of court within ______ days after service of this order.
Signed at ______________ , Louisiana this ____ day of _______________ 20____.
________________________________________
JUDGE
Note: Please add any necessary agencies below.
PLEASE SERVE:
Parish of ____________________
District Attorney ______________
Clerk of Court _____________________
Sheriff ______________________
Bureau of Identification & Information
Attn: Expungements
7919 Independence Blvd.
Baton Rouge, Louisiana 70806
and
_________________________________ ______________________________
Name of Agency Name of Agency
_________________________________ ______________________________
Attn: Attn:
_________________________________ _____________________________
Address Address
_________________________________ ______________________________
City/State/Zip City/State/Zip
La. Ch.C. ยง 925