Skip to content
[email protected]
1 (301) 928-1408
Home
Eligibility
Expungement Questionnaire
Payment
Contact Us
Expungement Questionnaire
"
*
" indicates required fields
Step
1
of
3
- Personal Information
33%
First Name
*
Middle Name
*
Last Name
*
Suffix
Jr.
Sr.
Any Alias/AKA (if applicable) :
Date Of Birth
*
MM slash DD slash YYYY
Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Email
*
Phone
*
Charge(s) Information
2. What charge(s) do you want to have expunged?
*
What City/County/State was the disposition rendered?
*
What was the disposition of the charge(s)?
*
(Check one of the following)
Acquitted
Dismissed
Probation Before Judgment (PBJ)
Nolle Prosequi
Stet
Guilty
Others
Disposition of the charge others
Date of the disposition?
MM slash DD slash YYYY
3. Date of Completion of sentence/program:
MM slash DD slash YYYY
3. Have you ever been convicted of any of the following ?
*
Yes
No
Convicted:
(Check one of the following )
Murder (first or second degree)
Sexual abuse of a minor
Rape
Sexual exploitation of a minor
Robbery with a dangerous weapon
Sex trafficking
Assault with intent to murder, rape ,or rob
Child pornography/abuse related offenses
Carjacking
Domestic assault
Kidnapping
Stalking
Arson
Violation of protective orders
Sexual offenses
Human trafficking
Neglect of a vulnerable adult
Firearms offenses
Home invasion
Sexual Offenses
Violation of protective orders
Domestic assault (1st or 2nd degree)
Perjury
Obstruction of justice
Escape from custody
Using or possessing a firearm in the commission of a crime
Convictions for crimes involving weapons or explosives
Convictions Resulting in Sex Offender Registration
Provide Details
Additional Charge History
4. Do you currently have any pending criminal charges against you?
*
Yes
No
Pending criminal charges details
5. Are you currently on probation, parole, supervised release or in a program?
Yes
No
Program Details
6. Have you received any new charges since the disposition of the charges you want to have expunged?
Yes
No
Details
Disposition of the charge(s)?
(Check one of the following
Acquitted
Dismissed
Probation Before Judgment (PBJ)
Nolle Prosequi
Stet
Guilty
Others
Disposition of the charge others
Date of Disposition of charges
MM slash DD slash YYYY
Date of Completion of sentence/program:
MM slash DD slash YYYY
Disclaimer:
This form is intended solely to gather preliminary information to assess potential eligibility for expungement and to assist in preparing an Expungement Petition. Completion of this form does not guarantee eligibility for expungement or approval of the petition. Final determination will be made by the court in the county of the legal case's final disposition. All information submitted will be used solely for preliminary eligibility assessment and will be handled with confidentiality.
Consent
*
By submitting this form, you agree that it will serve as your approval for us to use your digital signature for your expungement petition.