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Order For Expungement Of Criminal Offender Record EX-1 - Tennessee
| Order For Expungement Of Criminal Offender Record Form. This is a Tennessee form and can be used in Trial And General Sessions Courts Statewide . |
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(FOR TBI USE ONLY) State Identification Number: ______________________________ (FOR TBI USE ONLY) FBI Identification Number: ______________________________ ORDER FOR THE EX PUNGEMENT OF CRIMINAL OFFENDER RECORD (PLEASE PRINT OR TYPE) State of Tennessee vs _______________________________________________ Circuit Docket Number_______________________ Date Original Case was filed in Clerks Office___________________ General Sessions Docket Number_______________________ In the ____________________Court of __________________________ County, Tennessee at _______________________________ On the Motion or Petition of ______________________________________________________ Defendant/Arrest Information: _________________________________________________________________________ _____ ____ ___________ Defendant (name used at time of arrest) Race Sex Date of Birth ________________________________________________________________ _____________ __________________ Arresting Agency O CA# D ate of Arrest ___________________________________________________________________ _____ ___________________________ Charge 1(As shown on arrest fingerprint card) SSN# _________________________________________________________________________ _______________________________ Charge 2(As shown on arrest fingerprint card) _________________________________________________________________________________________ _______________ Charge 3(As shown on arrest fingerprint card) Disposition Information: _________________________________________________________________________ _______________________________ Final Charge 1 _________________________________________________________________________ _______________________________ Final Charge 2 _________________________________________________________________________ _______________________________ Final Charge 3 _________________________________________________________________________________________ _______________ Final Disposition _________________________________________________________________________ _______________________________ Diversion Date (if applicable) The defendant named above is entitled to have all PUBLIC RECORDS relating to the offenses listed above expunged according to the Tennessee Code Annotated provision marked below: Provision relating to Adults: Provisions relating to Juveniles: ___Charge has been dismissed (T.C.A. 40-32-101) ___Petition alleging delinquency not filed (T.C.A. 37-1-155) ___No true bill returned by Grand Jury (T.C.A. 40-32-101) ___Proceedings dismissed after petition is filed or the case transferred to Juvenile ___Verdict of not guilty returned by jury (T.C.A. 40-32-101 Court as provided in T.C.A. 37-1-109 (T.C.A. 37-1-155) ___Conviction which has by appeal been reversed (T.C.A. 40-32-101) ___Adjudicated not to be a delinquent child (T.C.A. 37-1-155) ___Nolle Prosequi entered in case (T.C.A. 40-32-101) ___Child has reached eighteen (18) years of age and there is no record that he ___Successful completion of all probation provisions and proceedings committed a criminal offense after reaching sixteen (16) years of age, unless against defendant have been discharged by the court such fingerprints were obtained on alleged charge which if committed by an (T.C.A. 40-35-313) adult would be a felony (T.C.A. 37-1-155) ___Suspension of prosecution pursuant to T.C.A. 40-15-105 ___Passage of six (6) months from date of liquor law violations defined by T.C.A. 57-3-412(a)(3)(c) or T.C.A. 57-5-301(e)(3) It is ordered that all PUBLIC RECORDS relating to such offense above referenced be expunged and immediately destroyed upon payment of all costs to clerk and that no evidence of such records pertaining to such offense be retained by any municipal, county, or state agency, except non-public confidential information retained in accordance with T.C.A. 10-7-504 and T.C.A. 38-6-118. APPROVED FOR ENTRY ________________________________________________ Entered this ______________ day of _______________, _______ Defendant/Attorney for Defendant ________________________________________________ __________________________________________________________ District Attorney General Judge Form EX-1 (Rev. 2003)
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