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Expungement Request AJ-058 - Maryland

Expungement Request Form. This is a Maryland form and can be used in Motor Vehicle Administration Statewide .
 Fillable pdf Last Modified 2/15/2013
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Motor Vehicle Administration 6601 Ritchie Highway, N.E. Glen Burnie, Maryland 21062 AJ-058 (11-12) Expungement Request The MVA will automatically expunge your driver record 3 years after your conviction, if the following criteria are met: · You have not been convicted of another moving violation or criminal offense involving a motor vehicle during the previous 3 years; and · Your driver's license has never been suspended or revoked; and, · You have never been convicted of, or been granted probation before judgment (PBJ) for Failing to remain at the scene of an accident resulting in bodily injury or death; or, Driving while intoxicated, driving under the influence, or driving impaired; or, A violation that is identical to or substantially similar to those listed above. If you do not meet the criteria for automatic expungement shown above, you may still be able to request manual expungement under certain circumstances. Your eligibility for manual expungement depends upon the offense for which you were convicted and the length of time since your last conviction. The MVA must follow Maryland law in deciding whether or not to grant manual expungement of a driver record. Listed below are examples for non-CDL drivers that would negate the possibility of expungement. · Alcohol offenses are never eligible for expungement. If you have received an alcohol offense, you must wait 10 years from your last moving violation conviction date or suspension withdrawal date to become eligible to have other driving record entries considered for expungement. · Any revocation or, two or more suspensions necessitates a 10 year wait from your last moving violation conviction date or suspension withdrawal date. · Any single suspension requires a 5 year wait from your last moving violation conviction date or suspension withdrawal date. · Any current suspension, revocation, restriction, or pending motor vehicle charge(s) will result in ineligibility. · Moving violations without suspensions, revocations, or alcohol offenses are eligible 3 years from your last moving violation conviction date. *Please note: All requests for expungement require a review of your complete driving record. There are no partial expungements. Driver's License Number Date of Birth Name - First Middle Last Street Address City State Zip Code I certify that I have have not been convicted for a criminal offense in which a motor vehicle was involved. If you have been convicted of such an offense please furnish the following: Location of Offense Date of Offense I certify that I have do not have any traffic summonses or criminal charges involving a motor vehicle now pending or outstanding, in Maryland or in any other state. If you have any such summonses or charges pending or outstanding, please complete the following: Nature of Pending Offenses Trial Date(s) I certify that the statements made above are true and correct to the best of my knowledge, information and belief. Signature Date Note: You will be advised by mail in approximately 4-6 weeks of the outcome of your request. Do not send a check or money order with this request. If a driving record is needed you may obtain a certified/non-certified copy at the Motor Vehicle Administration. Send this completed form to: Motor Vehicle Administration, Administrative Adjudication Division, Room 211 6601 Ritchie Highway N.E., Glen Burnie, MD 21062. For more information, please call: 410-768-7000 (to speak with a customer service representative). TTY for the hearing impaired: 1-800-492-4575. Visit our website at: www.MVA.Maryland.gov American LegalNet, Inc. www.FormsWorkFlow.com
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