Free 496.2 4-29-08.indd - Kentucky

NOTE: A SEPARATE PETITION MUST BE FILED FOR EACH CRIMINAL CASE AND THE CHARGE(S) MUST BE LISTED IN THIS PETITION FOR THE CHARGE(S) TO BE EXPUNGED. ADDITIONALLY, A COPY OF YOUR CURRENT AOC CRIMINAL HISTORY RECORD MUST BE ATTACHED TO THIS PETITION. AOC-496.2 Doc. Code: PEXC Rev. 9-08 Page 1 of 2 Commonwealth of Kentucky Court of Justice www.courts.ky.gov
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PETITION/ MOTION FOR EXPUNGEMENT (OF MISDEMEANOR OR VIOLATION CONVICTION)

COMMONWEALTH OF KENTUCKY PLAINTIFF VS. ________________________________NAME ________________________________ADDRESS ________________________________PHONE NUMBER DEFENDANT

Defendant's Birthdate:________________Defendant's SSN:__________________Violation/Arrest Date:_____________ Jail ID Number_____________________________(optional) Comes now, the Defendant herein, and petitions the Court, pursuant to KRS 431.078, to expunge the following misdemeanor or violation charge(s) in the above-referenced case: CHARGE: ____________________________________ CHARGE: ____________________________________ CHARGE: ____________________________________ CHARGE: ___________________________________ CHARGE: ___________________________________ CHARGE: ___________________________________

THERE IS A $100 FEE FOR EACH CHARGE SOUGHT TO BE EXPUNGED, PAYABLE AT THE TIME OF FILING. THE CLERK CANNOT TAKE YOUR PETITION/MOTION WITHOUT PROPER PAYMENT OF THE FEE(S). In support of this Petition, the Defendant states as follows: The Defendant was convicted of the misdemeanor(s) or violation(s) charged above; The above-stated offense(s) is/are not a sex offense(s) or an offense(s) committed against a child; The Defendant has no previous felony conviction; The Defendant has not been convicted of any other misdemeanor or violation offense within the five (5) years prior to the conviction sought to be expunged; 5. The Defendant has not, since the time of the conviction sought to be expunged, been convicted of a felony, misdemeanor, or a violation; 6. No proceeding concerning a felony, misdemeanor, or violation is pending or being instituted against Defendant; and the offense(s) sought to be expunged was/were offense(s) against the Commonwealth of Kentucky. 7. This petition is filed no sooner than five (5) years after completion of Defendant's sentence OR five (5) years after successful completion of the Defendant's probation, whichever is later. List the names and addresses of all victims of the crimes listed above and any other person(s) whom Defendant / Petitioner has reason to believe may have information relevant to the expungement: Vicitms: 1. 2. 3. 4.

Persons with relevant information:

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AOC-496.2 Rev. 9-08 Page 2 of 2

Case No._____________________

The Defendant prays that this Petition/Motion for Expungement of a Misdemeanor or Violation Conviction be granted and that this Court enter an Order that the following agencies expunge/seal any records in the agency(ies) custody regarding these charges: LIST AGENCIES HERE ______________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ Note: Defendant/Petitioner must sign this petition in the presence of the circuit clerk so that the clerk can notarize his/her signature. Date:__________________, 2_______. ___________________________________________ Defendant/Petitioner

Subscribed and sworn to before me by _________________________________________________________________ this _______ day of _________________, 2_______.

_____________________________________________ Clerk By:_______________________________________D.C.

NOTIFICATION OF EXPUNGEMENT HEARING This case is set for a hearing on _____________________________________________ at the hour of ____________ [ ]a.m. [ ]p.m. at the ________________________________ [ ]District [ ]Circuit Court. Dated this __________ day of ___________________________________, 2_________.

_____________________________________________ Clerk By:_______________________________________D.C.

FOR CLERK USE ONLY This Petition/Motion for Expungement was sent on the day of ,2 , to Defendant/Petitioner or his/her attorney; the County Attorney; all crime victim(s) indentified by Defendant/Petitioner or the court record sought to be expunged; and all other person(s) whom Defendant/Petitioner has reason to believe may have information relevant to the expungement. ______________________________________________ Clerk By:________________________________________D.C.

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