Pa Expungement Form PDF Details

Are you looking for a fresh start in your career and/or personal life? If so, the Pennsylvania expungement form may be your best bet towards beginning anew. Expungement is a legal process that allows individuals to erase certain non-violent criminal convictions from their records. Through this process, those eligible will have improved job prospects, access to housing and educational opportunities, increased rights when it comes to voting and more. Keep on reading if you are interested in learning more about the PA expungement form.

QuestionAnswer
Form NamePa Expungement Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namespa philadelphia expungement, pa expungement form, pa petition for expungement, pennsylvania petition expungement form

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County of Philadelphia

Commonwealth of Pennsylvania

1st Judicial District

 

 

v.

 

 

________________________________

 

Docket No:

-51-

-

-

Petition for Expungement Pursuant to Pa.R.Crim.P. 790

AND NOW, the petitioner avers the following and requests that this petition for expungement pursuant to

Pa.R.Crim.P. 790 be granted for the reasons set forth below.

PETITIONER INFORMATION

 

 

 

 

 

 

Full Name:

DOB:

 

Social Security Number:

 

 

 

 

 

 

Address:

 

Alias(es):

 

 

 

 

 

 

CASE INFORMATION

List name, address of the Judge of the Court of Common Pleas or Philadelphia Municipal Court who accepted the guilty plea or heard the case:

Judge:

 

Address:

 

 

 

 

Philadelphia Municipal Court or Court of Common Pleas Docket

OTN:

Number:

 

 

 

Name of Arresting Agency:

Date of Arrest:

 

Date on Citation or Complaint:

 

 

 

List name and mailing address of the affiant as shown on the complaint, if available:

 

 

 

Name of Affiant:

 

Address:

 

 

 

 

List specific charges, as they appear on the charging document, to be expunged and the disposition of each charge (please attach additional sheet(s) of paper if necessary):

PA Statute

Section

Subsection

Statute Description

Counts

Grade

Disposition

(Title)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If the sentence imposed included a fine, costs or restitution, has the amount due been paid?

Yes

No

List the reason(s) for the expungement (please attach additional sheet(s) of paper if necessary):

 

I have attached a copy of my Pennsylvania State Police Criminal History which I have obtained within 60 days before filing this petition.

I have not attached a copy of my Pennsylvania State Police Criminal History. State reason(s) below:

When this petition is filed with the Clerk of Courts, the petitioner shall serve a copy upon the attorney for the Commonwealth.

I, the undersigned petitioner, avers that the facts set forth in this petition are true and correct to the best of my personal knowledge and belief, and are made subject to the penalties of unsworn falsification to authorities under 18 Pa.C.S § 4904.

__________________________

________________

Signature of Petitioner

Date

1 of 3

 

Commonwealth of Pennsylvania

IN THE COURT OF COMMON PLEAS OF

 

PHILADELPHIA COUNTY, PENNSYLVANIA

v.

 

 

___________________________

CRIMINAL DIVISION

 

 

DOCKET NO:

 

 

-51- -_______________-______

 

Lower Court Docket Number (If Applicable):

 

-51-

- _______________-______

 

-51-

- _______________-______

 

-51-

- _______________-______

 

 

 

ORDER

AND NOW, this ____ day of ____________, 20___, after consideration of the petition for

expungement Pursuant to Pa.R.Crim.P. 790 presented by ______________________, it is ORDERED

that the Petition/Motion is ___________.

The defendant’s arrest record regarding these charges shall be expunged. Further, it is ORDERED that the arresting agency shall destroy all criminal records, fingerprints, photographic plates and photographs pertaining to the charge(s) specified below, which resulted from the arrest(s) of _______________________________________. In addition, all criminal justice agencies upon

which this order is served shall expunge and destroy the official and unofficial arrest and other criminal records, files and other documents pertaining to the captioned proceedings.

The information required under Pa.R.Crim.P. 790 appears on the attached page(s) which is hereby incorporated into this ORDER by reference.

BY THE COURT:

__________________________

2 of 3

Pursuant to Pa.R.Crim.P. 790, the following information is provided:

1.Petitioner Name:

2.Alias(es):

. Petitio er’s Address:

. Petitio

er’s Date of Birth:

/

/

 

. Petitio

er’s So ial Se urity Nu

er:

-

-

6.Name and address of the judge of the Court of Common Pleas or Philadelphia Municipal Court who accepted the guilty plea or heard the case:

7.Name and mailing address of the affiant as shown on the complaint, if available:

8.Docket Number:

9.Offense Tracking Number (OTN):

10.The date on the complaint, or the date of arrest, and if available, the criminal justice agency that made the arrest:

11.The specific charges, as they appear on the charging document, to be expunged and applicable dispositions (attach additional sheets if needed):

12.If the sentence includes a fine, costs, or restitution, whether the amount due has been paid:

13.The reason for expungement:

14.The criminal justice agencies upon which certified copies of the order shall be served: Philadelphia Police Dept and State Police Dept

3 of 3

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1. While filling out the philadelphia expungement, make sure to complete all of the important fields within its corresponding part. It will help to expedite the process, making it possible for your details to be processed efficiently and appropriately.

Writing segment 1 in pa petition expungement

2. Once your current task is complete, take the next step – fill out all of these fields - Philadelphia Municipal Court or, Section Subsection Statute, Address, Counts Grade Disposition, If the sentence imposed included a, I have attached a copy of my, When this petition is filed with, I the undersigned petitioner avers, knowledge and belief and are made, and Date with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Filling in section 2 of pa petition expungement

Be very mindful when filling in knowledge and belief and are made and I the undersigned petitioner avers, since this is the part where many people make a few mistakes.

3. The next segment is generally fairly easy, CRIMINAL DIVISION, DOCKET NO, Lower Court Docket Number If, ORDER, AND NOW this day of after, expungement Pursuant to PaRCrimP, and The defendants arrest record - all of these empty fields needs to be filled in here.

pa petition expungement writing process outlined (step 3)

4. This specific section arrives with the following blanks to consider: ORDERED that the arresting agency, The information required under, hereby incorporated into this, and BY THE COURT.

hereby incorporated into this, ORDERED that the arresting agency, and BY THE COURT of pa petition expungement

5. The final step to finish this form is essential. Make certain to fill out the required blanks, and this includes Pursuant to PaRCrimP the, Petitioner Name, Aliases, cid Petitiociders Address, cid Petitiociders Date of Birth, cid Petitiociders Socidial, Name and address of the judge of, accepted the guilty plea or heard, Name and mailing address of the, Docket Number, and Offense Tracking Number OTN, before using the document. Otherwise, it might produce an unfinished and possibly incorrect form!

Part # 5 of submitting pa petition expungement

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