CIRCUIT COURT
DISTRICT COURT OF MARYLAND FOR
City/County
Located at STATE OF MARYLAND
Court Address
Case No.
vs.
Defendant Address City, State, Zip Telephone No. - Home Telephone No. - Work
GENERAL WAIVER AND RELEASE
I, discharge
Complainant
, hereby release and forever , and the
Law Enforcement Agency
,
all of its officers, agents, and employees, and any and all other persons from any and all claims which I may have for wrongful conduct by reason of my arrest, detention, or confinement on or about
Date
.
This General Waiver and Release is conditioned on the expungement of the record of my arrest, detention, or confinement and compliance with Code*, Criminal Article, § 10-103(c) or § 10-105, as applicable, and shall be void if these conditions are not met. WITNESS my hand and seal this day of
Month
,
Year
.
TESTE:
(Seal)
Witness Signature
* References to "Code" in this Petition are to the Annotated Code of Maryland.
CC-DC/CR 78 (Rev. 6/2007)
RESET