forms and instructions can also be printed from the...

TO OBTAIN SEALINGEXPUNGING CERTIFICATION

PACKAGES TO REVIEW FREQUENTLY ASKED

QUESTIONS AND FOR CONTACT INFORMATION

PLEASE GO TO THE FDLE WEBSITE AT wwwfdlestateflusexpunge

FORMS AND INSTRUCTIONS CAN ALSO BE

PRINTED FROM THE CLERK OF COURTS WEBSITE AT wwwduvalclerkcom

FORMS PROVIDED AS A COURTESY OF THE

STATE ATTORNEYS OFFICE

Fourth Judicial Circuit of Florida Duval County Courthouse

Jacksonville Florida 32202

ANGELA COREY RONNIE FUSSELL STATE ATIORNEY CLERK OF COURT Tel (904)630-2400 Tel (904)255-2000

Fax (904)630-1848 Fax (904)255-2247 INSTRUCTIONS

If a Felony charge has originated out ofa Misdemeanor arrestiincident or vice versa you will need to include both case numbers on the Petition and the Order for the Judge Refer to Florida Statute 9430585 and 943059

Send ON L Y the FDLE Application fingerprint card certified disposition and $7500 money order to

FLORIDA DEPARTMENT OF LAW ENFORCEMENT Attn Quality Control Section 2331 Phillips Road PO Box 1489 Tallahassee Florida 32302-1489

Ifapproved you will receive a blue Certificate of Eligibility from FDLE

Once you have the certificate fill out blanks on the Petition to Expunge or seal Affidavit and Judges Order MAKE SURE YOU SIGN THE PETITION (You may want to retype these forms but it is not mandatory If you choose to write them please make it legible NOTE MOST JUDGES WILL NOT ACCEPT FILLED IN COpy OF RULE OF CRIMINAL PROCEDURE)

Make a copy of each document (Affidavit Petition 10 Expunge or Seal Judges Order and Certificate of Eligibility) Mail or hand deliver the ORIGINAL documents to the Courthouse

Duval County C01ll1holise 501 West Adams Street


(Misdemeanor-Room 1223 Felony-Room 2136

Mail or hand deliver the COPIES to

State Attorneys Office CO SealExpunge Division 220 East Bay Street 11th floor


(City Hall annex next to the old Courthouse)

BE ADVISED THIS PROCESS TAKES SEVERAL MONTHS

Most Frequently Asked Questions

I If I receive a full On June 10 1999 the Governor andNO Cabinet determined Ihallhe granling of a pardon can I have a full pardon does not remove any condition record sealed or of Ineligibility for sealing or expunging a

expunged criminal history record

If I have a record sealed or expunged in another state can I also have a Florida record sealed or expunged

c bull -f o If I have an out of state ~

U tU conviction will that

CIJ prevent me from having Q) my Florida record sealed on ~

or expunged

YES amp NO

YES

s ~ ~ Can I have more than NO ~ one date of arrest sealed ~ or expunged

o ~

~

If the other record was sealed or expunged as a matter of law (administratively) then yes you would be eligible However if it was sealed because you petitioned to have It done by court order then no you would not be eligible

Any criminal conviction will prevent an Individual from having a record sealed or expunged in the State of Florida regardless of whether that conviction occurred within the state or outside the state The conviction does not have to be on the arrest they are requesting

The statutes provide for relief only once In a lifetime unless both dates of arrest can be shown to be directly related to one another (Le FTA VOP etc)

Courtesy of the State Attorneys Office


I Approximately how The section receives anywhere from 500 to 700 applications each many applications are month

received by the section each month

I What items are necessary to have an application processed

s o I ~ What is disseminated on o Q) a sealed record

rjJ

o bO sect ~ ~ What is disseminated on ~ an expunged record ~ Q ~

There are four main items that must be included in an application package for it to be accepted for

processing

bull A completed (signed ampnotarized) application

bull A $75 processing fee bull A certified disposition bull A legible set of fingerprints recorded by a law enforcement agency on an applicant card

A sealed record will not be I

disseminated to anyone who is not entitled to It Those entities that are entitled to receive sealed Information will get the complete criminal history

The entities entitled to receive sealed information will receive the Identity segment of the criminal history record along with a caveat statement that says Criminal History Information has been Expunged from (hit record All other agencies will receive nothing


Most Frequently Asked Questions IWhat are the qualifications to have a criminal history record sealed

An individual may have a record sealed as long as they have no criminal convictions on their record If the Individual had the adjudication of guilt withheld hey are eligible to have It sealed as long as the charge Is not one that Is listed in s907041

I The charges have to be dropped What are the dismissed nolle pros no action no

qualifications to have a Information etc and the State Attorney has to fill out Section B ofcriminal history record the application In order to be expunged appro~ed for an expunction

o o I

Once you receive the certificate When I receive my ~ you are to file It with the clerksU certificate does that mean NO office In the county In which you (]J

were arrested once a court orderUJ my record is sealed or has been signed and a certified (]J expunged at that-time copy is received by FDLE then bJ) your record will be sealed or

sect expunged

I Does the issuance of~ The Issuance of a certificate does not guarantee that your record will be ordered

~ a certificate mean that my NO sealed or expunged It merely indicates to

U-l record will be ordered the court that you are eligible for the relief that you are requesting The decision to ~ seal or expunge your record rests solely sealed or expunged o With the presiding judge

~ Courtesy of the State Attorneys Office

Most Frequently Asked Questions If I had a criminal history record sealed and-then had it vacated could I apply for a new date of ~rrest

You could apply but your application would be denied The statute states that the Individual must never have had a record sealed or expunged Just because that one Is vacated It still counts as a prior action

J How long does it take to receive a response to my application

~ o I bull 14 Is my $75 processing fee j-J NOU refundableQ)

rJJ (j)

00 I Can FDLE give advice to == S other law enforcement NO

agencies or clerk of~ courts on the ~ management of their ~ sealed and expunged~ recordsQ ~

Current processing time is approximately 8 to 10 weeks from the date the application Is received in the office

On the back of the application where all of the instructions are it clearly states that the $75 processing fee Is non-refundable

Each agency has to determine for themselves with the aide of their legal counsel how to manage their own records FDLE Is unable to dictate the management of another agencys records

-It Courtesy of the State Attorneys Office


Will FDLE notify the agencies involved in YES my case that the record has been sealed or expunged

FDLE will send a notification letter to each agency that we know to be Involved with your case Informing them that we have received an order to either sea I or expunge the appropriate case This letter is a courtesy letter and does not Instruct the agencies to seal or expunge their records but merely informs them that an order has been received

Do I have to apply for a o ~ Certificate of Eligibility to ~

~ have my juvenile record o (l) sealed or expunged

rJ

~

sect bO

~ ~ ~ ~ Q ~

YESampNO

If the jJvenile arrest occurred prior to October 1 1994 you do not have to go through the application process as these records were not to be entered into the system at that time You would need to petition the court for a juvenile expunction order or obtain a juvenile expunction request from the arresting agency requesting the removal of the arrest from the system However I after October 1 1994 juvenile arrests began to be entered Into the system and for these arrests you would have to go through the application process and meet the same eligibility requirements as an adult


Most Frequently Asked Questions I

With the creation of s 9430585 andJuly 11992 When did the $943059 came the applicationapplication process process

begin

I bull Any and all law enforcementWho is entitled to receive There are several bull The Florida Barsealed information agencies entitled to bull Teacher Certification bull Agency for Health Care Adminreceive sealed bull HRSinformation

o ~

Aside from the agencies mentioned 14 ~ If I have a criminal history YES above you can legally deny that you() record sealed or were ever arrested ~

rJ expunged can I legally C) deny that I was ever bfj arrested ~ s ~

NO The statutes provide for relief only gtlt Can I have one date once In a lifetime You can either have JIl one record sealed or one expungedof arrest sealed and You cannot have one of each~

another expunged o ~ ~


REASONS AN APPLICATION FOR CERTIFICATE OF ELIGIBILITY TO SEAL OR EXPUNGE A CRIMINAL HISTORY RECORD WILL BE DENIED

Pursuant to Sections 59430585 and s943059 Florida Statutes a Certificate of Eligibility to expunge or seal a criminal history record cannot be issued under any of the following circumstances

1 The criminal history record reflects that you have been adjudicated guilty of a criminal offense or comparable ordinance violation or adjudicated delinquent for committing any felony or a misdemeanor specified in s943051 (3)b Certain driving violations are classified as criminal such as DUI reckless driving and (with some exceptions) driving while license is suspendedcanceledrevoked

2 The criminal history record reflects that you have been adjudicated guilty of or adjudicated delinquent for committing one or more of the acts stemming from the arrest or alleged criminal activity to which the application pertains

3 The criminal history record reflects that you have received a prior sealing or expunction of a criminal history record under s9430585 s943059 former s893 14 former s90133 former s943058 or from any jurisdiction outside the state

4 The criminal history record to which the application pertains relates to a violation of sect

393135 s 3944593 s787025 chapter 794 s79603 s80004 s81014 s817034 s8251025 s827071 chapter 839 s8470133 s8470135 s8470145 s893135 s916 1 075 a violation enumerated in s 907 041 or a violation of any offense qualifying for registration as a sexual predator under s77521 or for registration as a sexual offender under s9430435 Fla Stat with a finding of guilt or a plea or guilty or nolo contendre (without regard to whether adjudication was withheld)

5 The criminal history record reflects that you have another petition to seal or expunge pending before a court of competent jurisdiction

6 The criminal history record reflects that the court supervision applicable to the disposition of the arrest or alleged criminal activity to which the application pertains has not been completed

7 [For expunction only] The criminal history record reflects that some or all of the charges related to the arrest or criminal activity to which the application pertains were not dismissed prior to trial adjudication or the withholding of adjudication If no other disqualification applies the record would be eligible to be sealed

PLEASE NOTE The Governor and Cabinet of Florida acting in the capacity of the Board of Executive Clemency declared on June 10 1999 that the granting of a full pardon does not remove any condition of ineligibility for sealing or expunging a criminal history record which would otherwise be imposed by a conviction or withholding of adjudication pursuant to Sections 9430585 and 943059 Florida Statutes and acting in the capacity of agency head of the Department of Law Enforcement the Board directed FDLE to deny a Certificate of Eligibility to any person receiving a pardon who is otherwise ineligible for the sealing or expunging of the persons criminal history record

DISQUALIFYING CHARGES FOR EXPUNCTIONSEALING

A request for a certificate of eligibility for an expunction or sealing of a criminal history record will be denied if the defendant was found guilty or pled guilty or nolo contrendere even if the adjudication was withheld on any violation of the following

Offenses listed in S907041 FS 1 Arson 2 Aggravated Assault 3 Aggravated Battery 4 Illegal use of explosives 5 Child abuse or Aggravated Child Abuse 6 Abuse of an elderly person or disabled adult or aggravated abuse of an elderly person or disabled adult 7 Aircraft piracy 8 Kidnapping 9 Homicide 10 Manslaughter II Sexual Battery 12 Robbery 13 Carjacking _ 14 Lewd lascivious or indecent assault or act upon or in the presence ofa child under the age of 16 years 15 Sexual activity with a child who is 12 years of age or older but less than 18 years of age by or at solicitation ofa person in familial or

custodial authority 16 Burglary of a dwelling 17 Stalking or Aggravated Stalking 18 Act of Domestic Violence as defined in s74128 19 Home-invasion Robbery 20 Act of Terrorism as defined by s77530 21 Manufacturing any substances in violation of chapter 893 22 Attempting or conspiring to commit any of the above crimes

S393135 FS Sexual misconduct with developmentally disabled person and related offenses S3944593 FS Sexual misconduct with mentally ill person and related offenses S787025 FS Luring or enticing a child Chapter 794 FS Sexual Battery and rei ated offense S79603 FS Procuring person under 18 for prostitution S80004 FS Lewd or lascivious offenses committed upon or in the presence of persons less than 16 years of age S81014 FS Voyeurism S817034 FS Florida Communication Fraud Act (Scheme to Defraud or Organized Fraud as defined in s817034 FS) S8251025 FS Lewd or lascivious offense upon or in presence of elderly person or disabled adult S827071 FS Sexual performance by a child Chapter 839 FS Offenses by Public Officers and Employees S8470133 FS Showing etc obscene literature to minor S8470135 FS Computer pornography S8470145 FS Selling or buying of minors S893135 FS Trafficking in controlled substances S9161075 Sexual misconduct with mentally deficient or mentally ill defendant and related offenses A violation of any offense qualify for registration as a sexual predator under 577521 or for registration as a sexual offender tinder

59430435

All references are from Florida Statutes

GENERAL INSTRUCTIONS amp INFORMATION

1 Applicable law Sections 9430585 and 943059 Florida Statutes and Chapter 11C-7 Florida Administrative Code (FAC) govern the use of this application for the expunction or sealing of non-judicial criminal history records by criminal justice agencies These statutes and the implementing rules require that you obtain a Certificate of Eligibility from the Florida Department of Law Enforcement (FDLE) prior to requesting a court for an order to seal or expunge your non-judicial criminal history records and that you provide the information required by this application process

2 Please type or print all information except signatures Complete all required portions of the application and submit all required documents and the processing fee noted below under Section A Failure to disclose your social security number (SOC) may delay the processing time of your application If your application Is submitted without all the required Information documentation or the processing fee FDLE may reject your application

3 Mailing Information Mail your completed application package and fee to the following address

Florida Department of Law Enforcement ATTN ExpungeSeal Section

PO Box 1489 Tallahassee Florida 32302-1489

4 Contact Information FDLEs ExpungeSeal Section - (850) 410-7870

5 Optional Personal Review of your Florida criminal history record If you have questions about what appears in your Florida criminal history record maintained by FDLE you may wish to obtain a Personal Review of your record from FDLE pursuant to Chapter 11 CoB FAC before submitting this application fonm The Personal Review is optional and is not required for FDLE to process your Application for Certification of Eligibility for expunction or sealing of your record To obtain a Personal Review please complete and submit the enclosed FDLE Fingerprint form to FDLE at the address above If you submit the fingerprint form for your Personal Review please DO NOT send in the APPLICATION or the $7500 processing fee until the Personal Review is completed the results of your personal review may influence your decision to request the expunction or sealing of your criminal history record

SECTION A FOR ALL APPLICANTS

1 Complete every part of SECTION A Make sure your signature as the applicant is notarized

2 If you were given a Notice to Appear and not physically arrested for the charge(s) indicate the date of the Notice to Appear in the box marked Date of Arrest

3 NON-REFUNDABLE Processing Fee Submit with your application a money order or Cashiers check in the amount of $7500 made payable to the Florida Department of Law Enforcement (FDLE)

4 Submit the attached fingerprint form with your fingerprints as part of your application packet This form must be completed by authorized personnel at a law enforcement or criminal justice agency using only the attached FDLE Fingerprint form (If you have obtained a Personal Review send the fingerprint card back with the enclosed fingerprint form please resubmit the same form for the ExpungeSeal Certificate of Eligibility application)

5 Provide a certified copy of the final disposition(s) for each of the charges you list on your application Dispositions can usually be obtained from the office of the Clerk of Courts in the county where you were charged For Pretrial Intervention and other Diversion programs a certified letter of completion from the State Attorney or Statewide Prosecutor may substitute for a certified disposition If you received probation for any of the charges you must also submit a certified copy of the termination of your probation

SECTION B FOR EXPUNCTION APPLICANTS ONLY

1 Submit the application to the State Attorney or Statewide Prosecutor for completion of SECTION B only if you are applying to have your records EXPUNGED NOTE In addition to proper completion of Section B you must also submit the certified copies of disposition(s) and termination of probation required under Section A

SECTION C FOR FDLE USE ONLY

---

FLORIDA DEPARTMENT OF LAW ENFORCEMENT APPLICATION FOR CERTIFICATION OF ELIGIBILITY

PLEASE TYPE OR PRINT ALL INFORMATION

00 Eoshy

~ l Pot Pot lt

~I lt 8 EoshyU )ll 00

00

gt-8 ~ zEoshy~lt08 Eo-l Eo-Pot ltPot

lt~Zi lt01

Eo- 100 EoshyuQz z~0gtlt-)ll Eo-~ ~o 00 ~

U Z o ~ril Ul rilCi cnu

Last Name

Aliases Maiden Divorce

Date of Birth (DaB)

MONTH DAY YEAR Mailing Address

Permanent Address

Arresting Agency IDate(s) of Arrest

Select One ___Expunge Seal NOTE For Expunction applications the State Attorney or Statewide Prosecutor must complete Section B

Charge(s)

1

2

3

4

I hereby certify that the information contained herein is

true and correct to the best of my knowledge

Signature Date

State AttorneyStatewide Prosecutor I County

NOTARY

Sworn to and subscribed before me

-This __ Day 20

(Signature of Notary Public)

(Print Type or Stamp Commissioned Name of Notary

or Deputy Clerk of the Court)

Personally Known __ or Produced Identification __

Type of Identification Produced

I Circuit IReviewing Officer

Charge(s) Description

t

2

3

4

(904 Race

City

City

Pursuant to 59430585 Ra Stall certify (l)(a)that an indictment information or othercharging documenl was not filed or issued in the abovemiddotreferenced case or (b) Ihat an indictment iformation or other charging document if filed or issued in the case was dismissed Or nolle prosequi by the slate attomey or statewide prosecutor or was dismissed by a court of competent jurisdiction QjQ[ IQ td~1 diydieatlon or the withholdllQ III illljudication and (2) that the criminal history record does not relate to a violation of 5393135 53944593 s787025 chapter 794 S79603 580004 581014 5817034 s 82510255827071 chapter 839 s8470133 58470135 s8470145 5893135 bull 9161075 violation enumerated in s907041 or a violation of any offense quatifylng for registration as a sexual predator under 577521 or for registration as a sexual offender under 59430435 Ek~ without regalll 10 whether adjudication was withheld where the defendant was found guilty of or pled guilty or nolo contendere to any such offense or where the defendant as a minor was found to have comm~ted orpled guilly or nolo conlendere 10 committing such an offense as a delinquent act

My signature below indicates only that the above statutory criteria have been satisfied and does not imply an opinion that the record In question should or should not be expunged

Signature Title(Prosecuting Authority) Date

Middle NameFirst Name

Business PhoneResidence Phone

ISex ISocial Security

(

No

)

State Zip

State Zip

Florida Drivers License No

tase Numller ActionStatute Violation

AccUBLldget

Date Received

Check

Processed By

ExpungeSeal Section

10 DRI

Certification Status Approved Denied

Seal

Expunge B B

I certify Ihall have reviewed the states above-referenced case and believe thaI lhis applicant Is not eligible 10 have the criminal hislory record expunged for the following reason(s) pursuant to s9430585 Fla ruJL

All charges related to the arrest or criminal activity to which this application D pertains were not dismissed llillQ trial adjudication or the withholding of adjudication and as such said criminal history record if eligible must be sealed for at teast 10 years before It may be ellgibte to be expunged andlor

0 The criminal history record relatas to a violation of s393135 53944593 5787025 794796035800 0481014 s817034 58251025 S827-071~h~[9 58470133 s8470135 B470145 5893135 s9161075 a I in 5907 041 or a violation 01 any offense qualifying f~r~~yI~~(as a seXtlel predator under s77521 or for registration as a sexual under s9430435 EksectiLwilhoul regard to whether adjudication was withheld where the defendant was found guilty of or pled guilty or nolo contendere to any such offense or where the defendant as a minor was found to have committed or pled guilty or nola contendere to committing such an offense as a delinquent act andlor

o Other reason

Signature I V uoovuting Authority) Date

ExpungeSea Section

Date Received

Date Entered

Date Mailed

IMPORTANT A CERTIFICATE OF ELIGIBILITY IS VALID FOR 12 MONTHS FROM THE DATE OF ISSUANCE AFTER THAT TIME A NEW CERTIFICATE MUST BE APPLIED FOR

Revised July 2006 FDLE 40-021

-----------------------

----------------------

----------------------

----------------------

----------------------

------------------

FINGERPRINTS FOR APPLICATION FOR CERTIFICATION OF ELIGIBILITY

Name Last____________________________ First Middle

Alias(aka) Name Last First Middle

Place of RACE SEX DOB ____ SOC Birth _______________________

Please mail completed application and fingerprints to FDLE PO Box 1489 Tallahassee FL 32302 Attn ExpungeSeal Section

Signature of official taking fingerprints OR

Signature of person fingerprinted Date

2 R Index 4 R Ring 5 R Little3 R Middle1 R Thumb

91 Ring71 Index 10 L Little8 L Middle6 L Thumb

Right Four Fingers Taken SimultaneouslyR ThumbLeft Four Fingers Taken Simultaneously L Thumb

bull Social Security Number this information is voluntary failure to disclose may delay the processing time of your application

Form 40-024

DID YOU REMEMBER TO

D Sign and date your application in front of a notary

o Provide a certified disposition ot-your case

D Include your name racesex date of birth social security number and

signature on the fingerprint form

D Provide a $7500 check or money order made payable to

FDLE

D Have Section B completed by the State Attorneys Office if

seeking an expunction

o Include Attorneys letterhead if applicant is represented by

an attorney

tISVJ V DNIDNJldXtI HO~S~NtIWilJOltI

IN THE CIRCUITCOUNTY COURT OF THE FOURTH JUDICIAL CIRCUIT IN AND FOR DUVAL COUNTY FLORIDA

CASE NO--_____

DIVISION ____ STATE OF FLORIDA

Plaintiff

vs

(Name) ____________________

Petitio nerD efendant

PETITION TO EXPUNGE

The Petitioner (Name) petitions this honorable court under Florida Rules of Criminal Procedure 3692 and section 9430585 Florida Statutes to expunge all criminal history record information in the custody of any criminal justice agency and the official records of the court concerning the petitioners arrest on the ___ day of by the JacksonVille Sheriffs Office for (charge) and as grounds therefore shows

1 On the petitioner (Name) a (racesex) whose date of birth is was arrested by the Jacksonville Sheriffs Office and charged with (charge) _______________________

2 The petitioner has not been adjudicated guilty of nor guilty of committing any of the acts stemming from this arrest or alleged criminal activity

3 The petitioner has not been previously adjudicated guilty of a criminal offense or a comparable ordinance violation nor adjudicated delinquent for committing a felony or a misdemeanor specified in section 9430151 (3)(b) Florida Statutes

4 The petitioner has not secured a prior records expunction or sealing under section 9430585 or943059 Florida Statutes former section 943058 Florida Statutes former section 89314 Florida Statutes or former section 90133 Florida Statutes or any other law rule or authority

5 The petitioners record has been sealed under section 943059 Florida Statutes former section 943058 Florida Statutes former section 89314 Florida Statutes or former section 90133 Florida Statutes for at least 10 years or there has not been an indictment information or other charging document filed against the petition who is the subject of this criminal history record information or an indictment information or other charging document filed against the petition who is the subject of this criminal history information was dismissed by the prosecutor or the court

6 A Certificate of Eligibility for expunge of nonjudicial criminal history record issued by the Florida Department of Law Enforcement accompanies this petition

WHEREFORE the petitioner moves to expunge any criminal history record information and any official court records regarding this arrest by the Jacksonville Sheriffs Office for (charge)

CERTIFICATE OF SERVICE

1 HEREBY CERTI FY that a true and correct copy of the foregoing pleading has been served on the state Attorneys Office Fourth Judicial Circuit in and for Duval County Florida Jacksonville Sheriffs Office and the Florida Department of Law Enforcement on this __ day of

Signature Print Name Address CityState Zip Telephone

cc State Attorneys Office Jacksonville Sheriffs Office Florida Department of Law Enforcement Clerk of Court

You must give a copy of Petition Affidavit Order and Certificate of Eligibility to the State Attorney Office City Hall Annex 11th Floor Your petition will not be processed unless the State Attorney Office has copies of legal documents


CASE NO ________

DiViSiON____ STATE OF FLORIDA

Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT

STATE OF FLORIDA COUNTY OF DUVAL ~

am the defendantpetitioner in the above-styled cause and I do hereby swear or affirm that

1 I fully understand the meaning of all of the terms of this affidavit

2 I have never been adjudicated guilty ofa criminal offense or a comparable ordinance violation nor adjudicated delinquent for committing a felony or misdemeanor specified in section 943051 (3)(b) Florida Statutes

3 I was arrested on by the Jacksonville Sheriffs Office and I have not been adjudicated guilty of nor adjudicated delinquent for committing any of the acts stemming from that arrest or the alleged criminal activity surrounding my arrest

4 Lam eligible for the relief requested to the best of my knowledge and belief and do not have any other petition to expunge or seal pending before any court

5 I have never secured a prior records expunction or sealing under any law

6 An indictment information or other charging document was not filed against me for the above criminal transaction

Signature of Affiant

Sworn to and subscribed before me this day of ____________

NOTARY PUBLIC

Printed typed or stamped commissioned name of Notary Public


CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner

ORDER TO EXPUNGE RECORDS PURSUANT TO SECTION 9430585 FLORIDA STATUTES AND FLORIDA RULES OF CRIMINAL PROCEDURES 3692

THIS CAUSE having come on to be heard before me this date upon petitioners Petition to Expunge records concerning this arrest on (date) by the Jacksonville Sheriffs Office and the court being fully advised in the premises the court hereby finds the following

1 The petitioner has never previously been adjudicated guilty of a criminal offense or a comparable ordinance violation

2 The petitioner was nGlt adjudicated guilty of charges stemming from the arrest or criminal activity to which the petition pertains

3 The petitioner has not secured ~ prior records expunction or sealing

ORDERED AND ADJUDGED that the petition to expunge records is hereby granted All court records pertaining to the above-styled case shall be sealed in accordance with the procedures set forth in the Florida Rules of Criminal Procedure 3692 and it is further

ORDERED AND ADJUDGED that the clerk shall forward a certified copy of this order to the State Attorneys Office and the Jacksonville Sheriffs Office who will comply with the procedures set forth in section 9430585 Florida Statutes and appropriate regulations of the Department of Law Enforcement and who will further forward a copy of this order to any agency that their records reflect has received the instant criminal history record information and it is further

ORDERED AND ADJUDGED that the Jacksonville Sheriffs Office shall expunge all information concerning indicia of arrest or criminal history record information regarding this petitioner in accordance with the procedures set forth in section 9430585 Florida Statutes and 3692 FRCP

All costs of certified copies involved herein are to be borne by the petitioner

DONE AND ORDERED in Chambers at Jacksonville Duval County Florida this __ day of ________ 20__

JUDGE

cc Petitioner (name and address) State Attorneys Office Clerk of Court Florida Department of Law Enforcement Federal Bureau of Investigation shyJacksonville Sheriffs Office

JISV3 V DNI1VJIS lIO~ SLNJIWi130([


CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL

The Petitioner petitions this honorable court pursuantto Florida Rules of Criminal Procedure 3692 and section 943059 Florida Statutes to seal all criminal history record information in the custody of any criminal justice agency and the official records of the court concerning the petitioners arrest on the __day of by the Jacksonville Sheriffs Office for (charge) and as grounds therefore shows

1 On the __day of bull the petitioner _________ a (racesex) bull whose date ofbirth is bull was arrested by the Jacksonville Sheriffs Office and charged with _________________________

2 The petitioner has not been adjudicated guilty of any ofthe charges stemming from this arrest or alleged criminal activity

3 The petitioner has not been previously adjudicated guilty of a criminal offense or a comparable ordinance violation

4 The petitioner has not secured a prior records expunction or sealing under section 9430585 or 943059 Florida Statutes former section 943058 Florida Statutes former section 89314 Florida Statutes or former section 90133 Florida Statutes or any other law rule or authority

WHEREFORE the petitioner moves to seal any criminal history record information and any official court records regarding this arrest by the Jacksonville Sheriffs Office on the day of ____________


I HEREBY CERTIFY that a true and correct copy of the foregoing pleading has been served on the State Attorneys Office this __ day of __________


cc Seal ampExpunge Dept State Attorneys Office 220 East Bay Street Jacksonville FL 32202 Jacksonville Sheriffs Office Clerk of Court Florida Department of Law Enforcement


CASE NO

DIVISION

STATE OF FLORIDA Plaintiff

vs

(Name ____________________

Petitioner

AFFIDAVit

STATE OF FLORIDA ) COUNTY OF DUVAL )

I bull am the defendantpetitioner in the above-styled cause and I do hereby swear or affirm that


2 I have never been adjudicated guilty ofa crim inal offense or a comparable ordinance violation

3 I was arrested on the day of by the Jacksonville Sheriffs Office and I have not been adjudicated guilty of the charges stemming from that arrest or the alleged criminal activity surrounding my arrest

4 I am eligible for the relief requested to the best of my knowledge and belief and do not have any other petition to expunge or seal pending before any court

5 1have never secured a prior records expunction or sealing under any law

Signature

Sworn to and subscribed before me this day of ______________

NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner

ORDER TO SEAL RECORDS PURSUANT TO SECTION 943059 FLORIDA STATUTES AND FLORIDA RULES OF CRIMINAL PROCEDURES 3692

THIS CAUSE having come on to be heard before me this date upon petitioners Petition to Seal records concerning this arrest on the __ day of 20 __bull by the Jacksonville Sheriffs Office and the court being fully advised in the premises the court hereby finds the following


2 The petitioner was not adjudicated guilty of charges stemming from the arrest or criminal activity to which the petition pertains

3 The petitioner has not secured a prior records expunction or sealing

ORDERED AND ADJUDGED that the petition to seal records is hereby granted All court records pertaining to the above-styled case shall be sealed in accordance with the procedures set forth in the Florida Rules of Criminal Procedure 3692 and it is further

ORDERED AND ADJUDGED that the clerk shall forward a certified copy of this order to the State Attorneys Office and the Jacksonville Sheriffs Office who will comply with the procedures set forth in section 943059 Florida Statutes and appropriate regulations of the Department of Law Enforcement and

who will further forward a copy of this order to any agency that their records reflect has received the instant criminal history record information and it is further

ORDERED AND ADJUDGED that the Jacksonville Sheriffs Office shall Seal all information concerning indicia of arrest or criminal history record information regarding this petitioner in accordance with the procedures set forth in section 943059 Florida Statutes and 3692 FRCP


DONE AND ORDERED in Chambers at Jacksonville Duval County Florida this __ day of _______________20

JUDGE

cc Petitioner State Attorneys Office Jacksonville Sheriffs Office Florida Department of Law Enforcement Federal Bureau of Investigation Clerk of Court

Seal Expund 2013 1 of 2

Seal Expund 2013 2 of 2pdf

Fourth Judicial Circuit of Florida Duval County Courthouse


ANGELA COREY RONNIE FUSSELL STATE ATIORNEY CLERK OF COURT Tel (904)630-2400 Tel (904)255-2000

Fax (904)630-1848 Fax (904)255-2247 INSTRUCTIONS

If a Felony charge has originated out ofa Misdemeanor arrestiincident or vice versa you will need to include both case numbers on the Petition and the Order for the Judge Refer to Florida Statute 9430585 and 943059

Send ON L Y the FDLE Application fingerprint card certified disposition and $7500 money order to

FLORIDA DEPARTMENT OF LAW ENFORCEMENT Attn Quality Control Section 2331 Phillips Road PO Box 1489 Tallahassee Florida 32302-1489

Ifapproved you will receive a blue Certificate of Eligibility from FDLE

Once you have the certificate fill out blanks on the Petition to Expunge or seal Affidavit and Judges Order MAKE SURE YOU SIGN THE PETITION (You may want to retype these forms but it is not mandatory If you choose to write them please make it legible NOTE MOST JUDGES WILL NOT ACCEPT FILLED IN COpy OF RULE OF CRIMINAL PROCEDURE)

Make a copy of each document (Affidavit Petition 10 Expunge or Seal Judges Order and Certificate of Eligibility) Mail or hand deliver the ORIGINAL documents to the Courthouse

Duval County C01ll1holise 501 West Adams Street


(Misdemeanor-Room 1223 Felony-Room 2136

Mail or hand deliver the COPIES to

State Attorneys Office CO SealExpunge Division 220 East Bay Street 11th floor


(City Hall annex next to the old Courthouse)

BE ADVISED THIS PROCESS TAKES SEVERAL MONTHS








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NOTARY


-This __ Day 20








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2

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State Zip

State Zip



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10 DRI


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Expunge B B




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ExpungeSea Section

Date Received

Date Entered

Date Mailed



-----------------------

----------------------

----------------------

----------------------

----------------------

------------------












Form 40-024

DID YOU REMEMBER TO






FDLE




an attorney



CASE NO--_____


Plaintiff

vs

(Name) ____________________


PETITION TO EXPUNGE















CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE











or expunged

YES amp NO

YES


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2

3

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NOTARY


-This __ Day 20








t

2

3

4

(904 Race

City

City







(

No

)

State Zip

State Zip



AccUBLldget

Date Received

Check

Processed By

ExpungeSeal Section

10 DRI


Seal

Expunge B B




o Other reason


ExpungeSea Section

Date Received

Date Entered

Date Mailed



-----------------------

----------------------

----------------------

----------------------

----------------------

------------------












Form 40-024

DID YOU REMEMBER TO






FDLE




an attorney



CASE NO--_____


Plaintiff

vs

(Name) ____________________


PETITION TO EXPUNGE















CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE









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processing











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1

2

3

4



Signature Date


NOTARY


-This __ Day 20








t

2

3

4

(904 Race

City

City







(

No

)

State Zip

State Zip



AccUBLldget

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Processed By

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10 DRI


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Expunge B B




o Other reason


ExpungeSea Section

Date Received

Date Entered

Date Mailed



-----------------------

----------------------

----------------------

----------------------

----------------------

------------------












Form 40-024

DID YOU REMEMBER TO






FDLE




an attorney



CASE NO--_____


Plaintiff

vs

(Name) ____________________


PETITION TO EXPUNGE















CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE








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1

2

3

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NOTARY


-This __ Day 20








t

2

3

4

(904 Race

City

City







(

No

)

State Zip

State Zip



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Date Received

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Processed By

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10 DRI


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Expunge B B




o Other reason


ExpungeSea Section

Date Received

Date Entered

Date Mailed



-----------------------

----------------------

----------------------

----------------------

----------------------

------------------












Form 40-024

DID YOU REMEMBER TO






FDLE




an attorney



CASE NO--_____


Plaintiff

vs

(Name) ____________________


PETITION TO EXPUNGE















CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE








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Charge(s)

1

2

3

4



Signature Date


NOTARY


-This __ Day 20








t

2

3

4

(904 Race

City

City







(

No

)

State Zip

State Zip



AccUBLldget

Date Received

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Processed By

ExpungeSeal Section

10 DRI


Seal

Expunge B B




o Other reason


ExpungeSea Section

Date Received

Date Entered

Date Mailed



-----------------------

----------------------

----------------------

----------------------

----------------------

------------------












Form 40-024

DID YOU REMEMBER TO






FDLE




an attorney



CASE NO--_____


Plaintiff

vs

(Name) ____________________


PETITION TO EXPUNGE















CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE









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Charge(s)

1

2

3

4



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NOTARY


-This __ Day 20








t

2

3

4

(904 Race

City

City







(

No

)

State Zip

State Zip



AccUBLldget

Date Received

Check

Processed By

ExpungeSeal Section

10 DRI


Seal

Expunge B B




o Other reason


ExpungeSea Section

Date Received

Date Entered

Date Mailed



-----------------------

----------------------

----------------------

----------------------

----------------------

------------------












Form 40-024

DID YOU REMEMBER TO






FDLE




an attorney



CASE NO--_____


Plaintiff

vs

(Name) ____________________


PETITION TO EXPUNGE















CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE






begin


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Date of Birth (DaB)


Permanent Address



Charge(s)

1

2

3

4



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NOTARY


-This __ Day 20








t

2

3

4

(904 Race

City

City







(

No

)

State Zip

State Zip



AccUBLldget

Date Received

Check

Processed By

ExpungeSeal Section

10 DRI


Seal

Expunge B B




o Other reason


ExpungeSea Section

Date Received

Date Entered

Date Mailed



-----------------------

----------------------

----------------------

----------------------

----------------------

------------------












Form 40-024

DID YOU REMEMBER TO






FDLE




an attorney



CASE NO--_____


Plaintiff

vs

(Name) ____________________


PETITION TO EXPUNGE















CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE




















59430435



















---



00 Eoshy

~ l Pot Pot lt


00


lt~Zi lt01



Last Name


Date of Birth (DaB)


Permanent Address



Charge(s)

1

2

3

4



Signature Date


NOTARY


-This __ Day 20








t

2

3

4

(904 Race

City

City







(

No

)

State Zip

State Zip



AccUBLldget

Date Received

Check

Processed By

ExpungeSeal Section

10 DRI


Seal

Expunge B B




o Other reason


ExpungeSea Section

Date Received

Date Entered

Date Mailed



-----------------------

----------------------

----------------------

----------------------

----------------------

------------------












Form 40-024

DID YOU REMEMBER TO






FDLE




an attorney



CASE NO--_____


Plaintiff

vs

(Name) ____________________


PETITION TO EXPUNGE















CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE





















---



00 Eoshy

~ l Pot Pot lt


00


lt~Zi lt01



Last Name


Date of Birth (DaB)


Permanent Address



Charge(s)

1

2

3

4



Signature Date


NOTARY


-This __ Day 20








t

2

3

4

(904 Race

City

City







(

No

)

State Zip

State Zip



AccUBLldget

Date Received

Check

Processed By

ExpungeSeal Section

10 DRI


Seal

Expunge B B




o Other reason


ExpungeSea Section

Date Received

Date Entered

Date Mailed



-----------------------

----------------------

----------------------

----------------------

----------------------

------------------












Form 40-024

DID YOU REMEMBER TO






FDLE




an attorney



CASE NO--_____


Plaintiff

vs

(Name) ____________________


PETITION TO EXPUNGE















CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE




-----------------------

----------------------

----------------------

----------------------

----------------------

------------------












Form 40-024

DID YOU REMEMBER TO






FDLE




an attorney



CASE NO--_____


Plaintiff

vs

(Name) ____________________


PETITION TO EXPUNGE















CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE




DID YOU REMEMBER TO






FDLE




an attorney



CASE NO--_____


Plaintiff

vs

(Name) ____________________


PETITION TO EXPUNGE















CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE






CASE NO--_____


Plaintiff

vs

(Name) ____________________


PETITION TO EXPUNGE















CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE












CASE NO ________


Plaintiff

vs

(Name) ____________________

Petitioner

AFFIDAVIT











NOTARY PUBLIC



CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE





CASE NO ________

DIVISION -----shy

STATE OF FLORIDA

vs

(Name) _____________________

Petitioner











JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE






JUDGE




CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE






CASE NO

DIVISION

STATE OF FLORIDA

Plaintiff

vs

(Name) __________

Petitioner

PETITION TO SEAL












CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE









CASE NO

DIVISION


vs

(Name ____________________

Petitioner

AFFIDAVit








Signature


NOTARY PUBLIC



CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE





CASE NO

DIVISION

STATE OF FLORIDA

vs

(Name) ___________________

Petitioner












JUDGE






JUDGE




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