State of Alabama

Unified Judicial System PETITION FOR EXPUNGEMENT OF Case No.

Form CR-65 4/2015 RECORDS

(Section 15-27-1 et seq., Code of Alabama 1975) (Assigned by Clerk)

IN THE CIRCUIT COURT OF , ALABAMA

(Name of County)
[ ] STATE OF ALABAMA
[ ] MUNICIPALITY OF v.
(Court of Jurisdiction of case to be expunged) (Defendant/Petitioner)

PETITIONER
(Last Name) (First Name) (Middle Name)

(Address)

(Phone Number) (Email)

XXX XX -
(Social Security Number, Last four digits only)

CASE NUMBER TO BE EXPUNGED _________________________________

CHARGE TO BE EXPUNGED __________________________________________________________________________

(Only one offense per petition; Multi-count cases require multiple petitions)

I, the above-named Defendant/Petitioner, was charged with the above-named offense which is:
(Check ONLY one (1) of the five (5) options listed below; If none apply, charge is not eligible for expungement)
[ ] a misdemeanor criminal offense,
[ ] a violation,
[ ] a traffic violation,
[ ] a municipal ordinance violation,
[ ] a non-violent felony,
I hereby file this Petition with the Circuit Court to expunge records relating to the above charge because:
(Check ONLY one (1) of the seven (7) options listed below; If none apply, charge is not eligible for expungement)
[ ] The charge was dismissed with prejudice.
[ ] The charge was no billed by a grand jury.
[ ] I was found not guilty of the charge.
[ ] (Non-felony only) The charge was dismissed without prejudice more than two years ago, was not refiled, and I
have not been convicted of any other felony or misdemeanor crime, any violation, or any traffic violation,
excluding minor traffic violations, during the previous two years.
[ ] (Non-violent felony only) The charge was dismissed after successful completion of a drug court program, mental
health court program, diversion program, veteran's court, or any court-approved deferred prosecution program.
More than one year has passed from the successful completion of the program.
[ ] (Non-violent felony only) The charge was dismissed without prejudice more than five years ago, was not
refiled, and I have not been convicted of any other felony or misdemeanor crime, any violation, or any traffic
violation, excluding minor traffic violations, during the previous five years.
[ ] (Non-violent felony only) Ninety days have passed from the date of dismissal with prejudice, no-bill, acquittal,
or nolle prosequi and the charge has not been refiled.
State of Alabama PETITION FOR EXPUNGEMENT OF Case No.
Unified Judicial System
RECORDS
Form CR-65 4/2015 (Section 15-27-1 et seq., Code of Alabama 1975)
Page 2.

Attached to this Petition is: (Petition must include either item 1 or item 2; In either case, Petition must include item 3.)
[ ] (1) a certified record of arrest from the appropriate agency for the court record I seek to have expunged,
[ ] (2) a certified record of disposition, or a certified record of the case action summary from the
appropriate court for the court record I seek to have expunged;
[ ] (3) a certified official criminal record obtained from the Alabama Law Enforcement Agency (ALEA),

I am providing the following additional information as required by Ala. Code 1975, 15-27-1 et seq.:
(Petitioner must specify each of the following:)
1. Criminal charge from the record to be considered:

2. Grounds for, or reasons why you seek, expungement:

3. The agency or department that made the arrest:

4. Any agency or department where the Petitioner was booked or was incarcerated or detained pursuant to the
arrest or charge sought to be expunged: (If not booked, incarcerated or detained pursuant to arrest on the
above-listed charge, that must be indicated here.)

Further, I have satisfied and paid in full all terms and conditions, including court ordered restitution,
including interest, to any victim or the Alabama Crime Victims Compensation Commission, as well as court
costs, fines, or statutory fees ordered by the sentencing court to have been paid, absent a finding of indigency by
the court.
State of Alabama FOR EXPUNGEMENT OF RECORDS Case No.
Unified Judicial System (Section 15-27-1 et seq., Code of Alabama 1975)
Form CR-65 4/2015
Page 3.

I swear or affirm, under the penalty of perjury:

(1) that the allegations I have made in this Petition are true and correct;
(2) that I have satisfied the requirements set out in Ala. Code 1975, 15-27-1 et seq.
(3) that I [ ] have not [ ] have previously applied for an expungement in any other jurisdiction,
specifically

Case Number in COUNTY,

and, if I have applied for an expungement in any other jurisdiction, the expungement
was previously [ ] granted [ ] denied.

Signature of Petitioner/Affiant
[ ] pro se (Not represented by an attorney)

Personally appeared before the undersigned, an officer duly authorized to administer oaths,
, Petitioner named in the foregoing Petition, who being duly sworn, states
that the facts set forth in the foregoing Petition are true and correct to the best of their information and belief.

Sworn To And Subscribed Before Me This:

Date

Person Authorized to Administer Oaths or Notary Public

Name of Attorney Bar No.

Signature of Attorney

Business Address of Attorney

City State Zip Code

Telephone

Email Address
State of Alabama Case No.
Unified Judicial System PETITION FOR EXPUNGEMENT OF
RECORDS
Form CR-65 4/2015
Page 4.
(Certificate of Service)
(Section 15-27-1 et seq., Code of Alabama 1975)

I, _________________________, the Petitioner, certify that I have this date delivered a copy of the foregoing Petition For
Expungement of Records to the following courts, agencies, or other entities pursuant to Ala. Code 1975, 15-27-3(c):

District Attorney, Name: _________________________.

Address: ___________________________________Phone:_____________________________.

___________________________________

DATED this ____ day of _____________, 20___. METHOD OF SERVICE __ Personal __ Sheriff __ Other_________________

____________________________________________Petitioners/Servers Signature

Petitioners/Servers Address: ________________________________________; Phone: __________________

Law Enforcement Agency 1: __ State Trooper; __ Sheriff__; Municipal Chief of Police; __; Other _____

Name: ________________________;

Address: ___________________________________Phone:_____________________________.

___________________________________

DATED this ____ day of _____________, 20___. METHOD OF SERVICE __ Personal __ Sheriff __ Other_________________

____________________________________________Petitioners/Servers Signature

Petitioners/Servers Address: ________________________________________; Phone: __________________

Law Enforcement Agency 2: __ State Trooper; __ Sheriff__; Municipal Chief of Police; __; Other _____

Name: ________________________;

Address: ___________________________________Phone:_____________________________.

___________________________________

DATED this ____ day of _____________, 20___. METHOD OF SERVICE __ Personal __ Sheriff __ Other_________________

____________________________________________Petitioners/Servers Signature

Petitioners/Servers Address: ________________________________________; Phone: __________________

State of Alabama Case No.
Unified Judicial System PETITION FOR EXPUNGEMENT OF
RECORDS
Form CR-65 4/2015
Page 5.
(Certificate of Service)
(Section 15-27-1 et seq., Code of Alabama 1975)

Law Enforcement Agency 3: __ State Trooper; __ Sheriff__; Municipal Chief of Police; __; Other _____

Name: ________________________;

Address: ___________________________________Phone:_____________________________.

___________________________________

DATED this ____ day of _____________, 20___. METHOD OF SERVICE __ Personal __ Sheriff __ Other_________________

____________________________________________Petitioners/Servers Signature

Petitioners/Servers Address: ________________________________________; Phone: __________________

Clerk of the Circuit Court of the Jurisdiction where the Petition is filed:

Circuit Clerk, Name: _____________________________________;

Address: ___________________________________Phone:_____________________________.

___________________________________

DATED this ____ day of _____________, 20___. METHOD OF SERVICE __ Personal __ Sheriff __ Other_________________

____________________________________________Petitioners/Servers Signature

Petitioners/Servers Address: ________________________________________; Phone: __________________

(If applicable):

__District Clerk / __Municipal Clerk, Name: ___________________________________;

Address: ___________________________________Phone:_____________________________.

___________________________________

DATED this ____ day of _____________, 20___. METHOD OF SERVICE __ Personal __ Sheriff __ Other_________________

____________________________________________Petitioners/Servers Signature

Petitioners/Servers Address: ________________________________________; Phone: __________________

 PETITION FOR EXPUNGEMENT OF
State of Alabama Case No.
Unified Judicial System RECORDS
(Instructions for Petitioner)
Form CR-65 4/2015 (Section 15-27-1 et seq., Code of Alabama 1975)
Page 6.

PAGE 1 The second paragraph on page 2 corresponds to a section of

the statute which requires that petitioners specify the listed
The Petitioner must fully complete the entire title section items. A response is required as to each point. If any of the
(above the black line) of the Petition. items do not apply, the Petitioner must specify that they do not
The first line refers to the circuit court of the county in which apply and, if possible, why they do not apply. The Petitioner
the Petition is to be filedthe Petition must be filed in the must include an address for each agency, department, etc.
county where the Petitioner was arrested or where the case listed. Additional pages may be attached if necessary.
was disposed. For example: A municipal case in Huntsville, The final paragraph of page 2 relates to the disposition of the
AL would be properly filed in the Circuit Court of Madison underlying case. Any and all conditions of the court of
County. disposition must be satisfied in order for the charge to be
The second line must match the title of the underlying case eligible for expungement. This includes ANY and ALL fines
the case the Petitioner is petitioning to have expunged. fees or other payments to the court.

The Petitioner section must be completed in full with the

Petitioners CURRENT contact information. PAGE 3
The Petitioner must list the full case number of the underlying The final page is an averment under oath that the entire
casethe case the Petitioner is petitioning to have expunged. Petition is true and correct and that the Petitioner is eligible
There may be more than one charge on any given case for expungement, and includes information from the Petitioner
number, but each petition must be limited to one charge. If about other expungement petitions. Intentionally giving false
the Petitioner seeks to have each charge expunged, the information to the Court may carry penalties.
Petitioner must fill out a separate petition for each charge.
All previous petitions for expungement must be disclosed.
The bottom half of the page asks two qualifying questions Additional pages may be attached, if necessary.
about the underlying case. Cases eligible for expungement
satisfy one of the options completing the first statement AS The Petitioner must sign this document under oath and the
WELL AS one of the options completing the second signature must be verified by an official authorized to
statement. Note that some of the options completing the administer oaths or notary public.
second statement are limited to certain circumstances. The At the bottom of page 3 is a section for information about the
Petitioner must check one, and only one, option to complete Petitioners attorney and for the attorneys signature. If the
each of the two statements. Petitioner IS represented by an attorney, the attorney must
sign where indicated. If the Petitioner IS NOT represented by
PAGE 2 an attorney, pro se must be indicated under the Petitioners
signature.
The first paragraph on page 2 refers to attachments to the
Petition. Ala. Code 15-27-3(b) requires, as a minimum,
that petitioners include BOTH a certified record relating to the PAGE 4
charge from the local entity (either law enforcement or court)
AND a certified criminal record from the state agency (the Ala. Code 15-27-3(c) requires the Petitioner to serve the
Alabama Law Enforcement Agency). Accordingly, this district attorney, the law enforcement agency, and clerk of
Petition will be processed even if only the minimum court of the jurisdiction for which the records are sought to be
information required under the statute is supplied; expunged. The Petitioner is relied upon to provide the Court
HOWEVER, the expungement order may be impossible to and ultimately the Alabama Law Enforcement Agency
fully carry out if the Court and the Alabama Law Enforcement information necessary to contact every court, law enforcement
Agency are not made aware of the location of ALL records agency or other entity in possession of records the Petitioner
relating to the underlying charge. It is, therefore, seeks to have expunged.
recommended that the Petitioner attach to the Petition
certified copies of arrest, booking, or incarceration records The Petitioner must certify to the Court that each of the courts,
from ALL law enforcement agencies (city, county, and state), agencies, or other entities holding records relating to the
and certified copies of case action summaries or dispositions underlying case has been served. Page 4 is a form
from ALL court clerks (municipal, district, and circuit) who certification for the courts, agencies, or other entities served
may hold records of any kind relating to the underlying case. with this Petition and their addresses. Additional pages may
be attached if necessary.
NOTE: Any information (including mailing addresses)
provided regarding courts, agencies, or other entities holding
records relating to the underlying case will expedite the
execution of an expungement order if one is entered.