Expungement Questionnaire - Clean Record DMV

Step 1 of 4 - Personal Information

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First Name*

Middle Name

Last Name*

Suffix

Any Alias/AKA (if applicable) :

Date Of Birth*

MM slash DD slash YYYY

Address

Street Address Address Line 2 City State ZIP Code

Email*

Phone*

Charge(s) Information

1. What charge(s) do you want to have expunged?*

1a. What City/County/State was the disposition rendered?*

2. Do you know how the case(s) you want expunged ended?*

Yes

2a. Put a check box beside each choice that applies to how your case ended.

Dismissed

Not Guilty

Nolle Prosequi

Probation Before Judgement (PBJ)

STET

Guilty

Released Without Charge

Not Sure

2b.Provide Details*

3. Do you currently have a pending/open/active charge/case anywhere in the United States?*

Yes

⚠ Important Eligibility Information

You cannot file for an expungement under Maryland law if you currently have any pending criminal proceedings. Before your record can be considered for expungement, all pending criminal matters must be resolved and closed. Please provide details regarding your pending case(s) below.

4. Are you currently on parole, probation or court ordered supervision?*

Yes

⚠ Expungement Eligibility Information

Based on your response, you may not currently be eligible to file for expungement under Maryland law. In most cases, individuals must complete all terms of their sentence, including probation, parole, supervised release, or any court-ordered program, before becoming eligible to apply for expungement. Once you have successfully completed these requirements, we invite you to return and complete this eligibility questionnaire again to determine whether you may qualify for expungement.

Charge(s) History

5. Since the case you want expunged ended, have you been charged with or convicted of another offense anywhere in the United States?*

Yes

5a. Did the charge(s) result in a conviction?

Yes

6. Have you received a Pardon from the Governor of Maryland?*

Yes

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.

7. Were you referred to Clean Record DMV by someone?*

Yes

7a. Please provide the name of the person or organization who referred you.

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.

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