ERASURE OF RECORD PETITION/ORDER
JD-JM-12 Rev. 3-09 C.G.S. §§ 46b-133a, 46b-146 Pr. Bk. §§ 27-8A(c), 27-9(c)
Instructions To Person Asking To Have Record Erased
Complete Section I below, sign it in front of a notary public, an assistant clerk of the Superior Court, or a Commissioner of the Superior Court, and file the original with the court. Keep a copy for yourself.
STATE OF CONNECTICUT
JUVENILE MATTERS www.jud.ct.gov
Instructions To Court Staff
Send a copy to all depositories of police and court records pertaining to the charge of delinquency or that a family is a family with service needs.
Address of Court Name of Child Police Department Date of Birth
Date of Disposition/Discharge
Police Department Case Number
Section I -- Petition For Erasure Of Record
I swear to the following facts, and ask that the court erase all police and court records about the child named above: At least 2 (two) years or, in the case of a serious juvenile offense conviction, 4 (four) years have passed from the date the child was discharged from the supervision of the Superior Court or the child was discharged from the custody of the Department of Children and Families or the child was discharged from the care of any other institution or agency the child was admitted to by the court and no other juvenile proceeding has been started against the child and the child has not been found guilty of a crime, if the child has reached age 16 during the 2 or 4 year period.
Date of Petition Signed (Petitioner (Child/Parent/Guardian, or Attorney)) Date Address of Petitioner
Subscribed and Sworn to before me:
Signed (Notary Public, Assistant Clerk, Commissioner of the Superior Court )
Granted, all police and court records about the child are erased under section 46b-146 of the General Statutes. Denied.
By the Court (Print or type name of Judge) Signed (Judge) Date Signed
Section II -- Order For Erasure By Operation Of Law
Pursuant to the provisions of C.G.S. § 46b-146 The charge(s) of delinquency that a family is a family with service needs (FWSN), arising out of the complaint(s)/petition(s) in the matter of the above-named child was (were) dismissed. Pursuant to the provisions of C.G.S. § 46b-133a(b) The above-named child was charged with delinquency and thirteen months have elapsed since: a nolle prosequi has been entered as to the charge(s) in the complaint(s) OR the charge(s) in the complaint has/have been dismissed without prejudice. Pursuant to P.B. § 27-8A(c) the child has successfully completed nonjudicial delinquency handling and the matter is dismissed and erased for all purposes except subsequent consideration for nonjudicial handling under P.B. § 27-4A. Pursuant to P.B. § 27-9(c) the child has successfully completed a diversion to FWSN services pursuant to C.G.S. § 46b-149(g) and the matter is dismissed and erased for all purposes except subsequent consideration for nonjudicial handling under P.B. § 27-4A.
Now, therefore, it is ordered that all police and court records pertaining to such charge(s) are erased.
By the Court (Print or type name of Judge) On (Date) Signed (Judge) Date Signed
Notice to Depositories of Police and Court Records
Upon the entry of such an erasure order, all references including arrest, complaint, referrals, petitions, reports and orders shall be removed from all agency, official and institutional files, and a finding of delinquency or that the child was a member of a family with service needs shall be deemed never to have occurred. The persons in charge of such records shall not disclose to any person information pertaining to the record so erased, except that the fact of such erasure may be substantiated where, in the opinion of the court, it is in the best interests of such child to do so.